Osteoporosis in children and adolescents: Diagnosis, risk factors, and prevention

Bone mass acquired during childhood and adolescence is a key determinant of adult bone health. Peak bone mass, which is achieved in late adolescence, is a main determinant of osteoporosis in adulthood. Therefore, any factor a dversely impacting on bone acquisition during childhood or adolescence can potentially have long-standing detrimental effects on bone health predispos ing to osteoporosis and fracture risk. Thus, osteoporosis can well have its origin in childhood and adolescence. Pediatricians should be playing an ac tive role in osteoporosis diagnosis and prevention. It is increasingly reco gnized that osteoporosis may occur in some disorders of children and adoles cents. In this paper we review the diagnostic criteria of osteopenia/osteop orosis by densitometric assessment of bone mineral density, the contributin g factors, and the mechanisms whereby several disorders may affect the acqu isition of bone mass in children and adolescents. Finally, some recommendat ions to optimize peak bone mass in order to prevent osteopenia/osteoporosis are suggested.