Bone Health in Children With Risk Factors for Low Bone Mass

Purpose: To describe clinical and biological characteristics of pediatric patients with at least one risk factor (RF) for low bone mass for chronological age (LBMca)/childhood osteoporosis (cOP) and to assess its influence on bone mineral density (BMD).Methods: Patients between 2 and 20 years of age with at least 1 RF were recruited. Daily calcium intake, number of previous fractures and other RFs and their distribution among different groups were assessed. Spine and whole body DXA and vertebral morphometry were performed.Results: 103 patients were included. Mean age was 9.8 years old. 52.4% were female. Of the RFs, 84.5% presented insufficient calcium intake, 38.8% were receiving or had received corticosteroids, 31.1% were receiving other treatments with osteotoxic potential, 13.6% led a sedentary lifestyle, 12.6% presented history of fractures, and up to 8.1% had hypovitaminosis D. 38% of the cohort had 2 RFs, 31% had 3 RFs, 15% had 4 RFs, and 12% associated 5 or more RFs. 10.5% met LBMca criteria and 4.8% met cOP criteria. 73% of vertebral BMD was justified by age and hypovitaminosis D (positive effect), and male sex and Hispanic ethnicity (negative effect). 82% of total body less head BMD was justified by age (positive effect), and Hispanic ethnicity and sedentary lifestyle (negative effect).Conclusions: Pediatric populations with risk of LBM/cOP have 2 or more risk factors. Up to 10.5% of children with RFs present LBM and 4.8% have an unknown cOP. RFs related to changes in BMD are age, sex, sedentary lifestyle, ethnicity, and hypovitaminosis D.