Bone mass acquisition in healthy children

Abstract

Although 80% of the variance in bone mass is determined genetically, there are many other factors which influence the accumulation of bone in early life and affect future risks of osteoporosis. This review considers the genetic, fetal, and environmental influences on bone mass acquisition in healthy children, and highlights important areas where paediatricians may have a role by counselling children and their families to adopt a healthy lifestyle which promotes bone health.

Figure 1

Schematic representation of the changes of bone mass with age as measured by DEXA. The dotted line shows the theoretical consequence of a reduction in peak bone mass.

Figure 2

Left: in the absence of DKK-1, LRP5 interacts with the Wnt receptor and activates intracellular signalling leading to bone formation. Centre: DKK-1 prevents this interaction and an active signalling complex does not occur. Right: mutant LRP5 preferentially forms complexes with Wnt, leading to constitutive activation of Wnt signalling and bone formation.