Bone Mineral Accrual From Adolescence Into Young Adulthood and Peak Bone Mass: A Longitudinal Cohort Study.
Level 3 - non-randomized controlled study
Retrospective longitudinal cohort study with repeated assessments.
PubMed 41163931 · doi:10.1002/hsr2.71411
What was done
A retrospective cohort study evaluated 159 participants across growth and young adulthood to assess longitudinal changes in total body bone mineral content (TBBMC), bone mineral density (TBBMD), and bone mineral apparent density (BMAD). Participants underwent dual-energy x-ray absorptiometry (DXA) across two assessment timepoints. Anthropometry, pubertal staging, socioeconomic status (SES), and habitual exercise were assessed via structured physician-administered questionnaires, and linear mixed models analyzed determinants of bone accrual.
What was found
The highest rates of change for TBBMC and TBBMD occurred between ages 9–11 years and at Tanner stage 1, with males demonstrating higher accrual rates than females up to age 18. Peak TBBMC and TBBMD were reached at 25.7 and 26.2 years in males, compared to 24.8 and 24.0 years in females. Site-specific BMAD peaked at 21.2 years (femoral neck) and 23.8 years (lumbar spine) in males, versus 24.8 and 24.1 years in females. Linear mixed models showed that older age, higher BMI, male sex, higher SES (significant for BMD), and physical activity were positively associated with TBBMC and TBBMD.
Why it matters
These findings delineate sex-specific timing for peak bone mass attainment in the mid-twenties, supporting targeted early-life lifestyle interventions—such as regular physical activity—to optimize peak skeletal reserves before age-related decline.
Limits
The study is limited by a modest sample size (n = 159) and only two DXA measurement points per subject. The retrospective observational design relies on questionnaire-based reporting for exercise and SES, and the abstract does not report specific effect sizes, confidence intervals, or cohort demographic characteristics.
Cited by
- supports Peak muscle mass and peak bone density generally occur around 25 years of age before beginning to decline.