نبذة مختصرة : Background Puberty is a critical period for bone mass accrual, and late puberty in boys is associated with reduced bone mass in adult men. The role of variations in pubertal timing within the normal range for adult fracture risk in men is, however, unknown. We, therefore, assessed the association between age at peak height velocity (PHV), an objective measure of pubertal timing, and fracture risk in adult men. Methods and findings In the BMI Epidemiology Study Gothenburg, 31,971 Swedish men born between January 1, 1945, and December 31, 1961, with detailed growth data (height and weight) available from centrally archived school healthcare records and the conscription register were followed until December 31, 2016. Age at PHV was calculated according to a modified infancy–childhood–puberty model, and fracture information was retrieved from the Swedish National Patient Register. The mean ± SD age at PHV was 14.1 ± 1.1 years. In total, 5,872 men (18.4%) sustained at least 1 fracture after 20 years of age and 5,731 men (17.9%) sustained a non-vertebral fracture after 20 years of age during a mean ± SD follow-up of 37.3 ± 11.7 years. Cox proportional hazards models adjusted for birth year and country of origin revealed that age at PHV was associated with the risk of any fracture and non-vertebral fracture. Participants with age at PHV in the highest tertile (after 14.5 years of age) were at greater risk of any fracture (hazard ratio [HR] 1.15, 95% confidence interval [CI] 1.08–1.22, P < 0.001) and non-vertebral fracture (HR 1.16, 95% CI 1.09–1.24, P < 0.001) compared with those with age at PHV in the lowest tertile (at 13.6 years of age or younger). Additional adjustments for birthweight, childhood BMI, adult educational level, and young adult height did not attenuate the associations between age at PHV and adult fracture risk. Limitations of this study include the inability to adjust for important risk factors for fracture, inadequate power to assess the relation between pubertal timing and specific fracture types, and the limited generalizability to other populations. Conclusions In this study, we observed that late pubertal timing was associated with increased adult fracture risk in men. These findings suggest that information on pubertal timing might aid in the identification of those men at greatest risk of fracture.
In a cohort study of men born in Sweden, Liesbeth Vandenput and colleagues investigate whether the timing of puberty can predict the risk of fracture later in life.
Author summary Why was this study done? It is well known that pubertal timing is associated with peak bone mass and bone health later in life, with later puberty in boys being associated with reduced bone mass in adult men. However, it remains unknown whether pubertal timing is associated with the clinical endpoint fracture. This study investigates the predictive role of variations in pubertal timing for adult fracture risk in men. What did the researchers do and find? We conducted a population-based cohort study that included 31,971 Swedish men born in 1945–1961. Using age at peak height velocity as an objective measure of pubertal timing, we found that pubertal timing in boys was associated with adult fracture risk. Men with late pubertal timing (age at peak height velocity in the highest tertile) had a 15% higher risk of sustaining a fracture compared with those with early puberty (age at peak height velocity in the lowest tertile). What do these findings mean? These results highlight the importance of pubertal timing as a risk marker for adult fracture in men. These findings suggest that information on pubertal timing might help to identify those men at greatest risk of fracture.
Processing Request
No Comments.