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Articles

Title: Osteoporosis in children and adolescent

Author:
Renata Saganowska, Brunon Lalik
Language:
PL
Journal:
Pediatric Review
Year:
2006
Volume:
36
Number:
2
Start page:
143
Final page:
150
ISSN:
0137-723X
Keywords:
osteoporosis in children and adolescents, osteoporosis risk factors, bone mineral density, bone quality
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Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, resulting in fragility and increased fracture risk. The diagnosis of osteoporosis is based on the measurement of bone mineral den-sity (BMD) of femoral neck using dual energy X-ray absorptiometry (DXA). However, the assessment of fracture risk based on a single BMD measurement alone is insufficient because apart from bone density, bone strength is determined by bone quality. Bone quality refers to architecture, turnover, damage accumulation (microfractures) and mineralization. In predicting the risk of fractures some factors, such as genetic disposition, age, sex, race, physical build and activity, nutritional deficiencies, especially vitamin D insufficiency should be taken into account. Bone formation and bone resorption last lifelong, however their dynamics varies. Childhood and adolescence are periods of very intensive bone turnover and achieved peak bone mass (PBM) determines bone density and risk of osteoporosis in adulthood. Thus, prevention and/or treatment of osteoporosis are very important at that age. In spite of common opinions osteoporosis occurs not only in adults but also in children and adolescents. In childhood secondary osteoporosis dominates, which is a complication of chronic diseases or their treatment, especially long-term corticosteroid therapy. Primary osteoporosis is rare. The paper presents current definitions, opinions on the pathogenesis, risk factors, clinical manifestations, diagnostics and treatment of osteoporosis in childhood and adolescence.