BoneKEy-Osteovision | Perspective

Pubertal timing, peak bone mass and fragility fracture risk

Jean-Philippe Bonjour
Thierry Chevalley

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DOI:10.1138/20060247

Abstract

Late pubertal timing is associated with relatively low peak bone mass (PBM) and increased risk of fragility fracture in adulthood. Several observations suggest that the relationship between pubertal timing and PBM cannot be explained solely by variation in the duration of sex hormone exposure. In delayed or late puberty, reduced bone mass gain can be observed before the onset of sexual maturation. In the general population, both pubertal timing and PBM, with its strength components, are traits characterized by large variance and Gaussian distribution. Both variables are under the strong influence of heritable factors and can be moderately affected by common environmental determinants. It is suggested that pubertal timing, PBM and consecutive osteoporosis risk later in life may be part of a common programming in which both genetic factors and in utero influences are important determinants. Both variables probably arise from the additive influences of multiple genes. The identification of allelic variants of candidate genes that are associated with both pubertal timing and bone mass acquisition during growth may enhance our understanding of the mechanisms that determine the risk of osteoporosis and also disorders of human reproduction. Finally, fractures experienced by healthy children during growth can be associated with late pubertal timing and low bone mass observed both before and after puberty. This also suggests that common programming links the determinants of sexual maturation and bone development.

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