Peak bone mass is the amount of bony tissue present at the end of the skeletal maturation. The bone mass of a given part of the skeleton is directly dependent upon both its volume and the density of the mineralized tissue contained within the periosteal envelope. The peak bone mass is used to determine the risk of an osteoporotic fracture. The peak bone mass depends on factors like sex, race and genes. As a result, the peak bone mass is 30% higher in men than in women. It may vary a lot among women as it depends on several genes that influence bone mass, bone turnover, and bone loss. During the early years the difference between peak bone mass in female child and that in a male child is not as significant as it gets post puberty which affects bone size much more than the volumetric mineral density. The gender difference in bone mass increases during puberty. The prolonged bone maturation period in males than in females is believed to be the reason behind the difference in peak bone mass.
A recent cross-sectional study of bone mass measurements in 265 premenopausal females between the age of 8 and 50 years, found that most of the bone , ass at multiple skeletal locations is usually accumulated by late adolescence. The gain in bone mass in premenopausal adult women is believed to be due to the continuous periosteal expansion with age. Since rapid skeletal mineral acquisition at all sites occurs relatively early in life, the exogenous factors which might optimize peak bone mass need to be more precisely identified and characterized.
The peak bone mass in a woman depends a lot on what she eats during the early life. Women who ate diets rich in calcium and vitamin D during childhood and adolescence are supposed to have denser bones during adulthood. When girls and women have too little body fat to support menstruation, it directly affects their bones and they are at a higher risk of developing osteoporosis. Regular weight-bearing exercises during the early years contribute a lot to the peak bone mass or density. Any activity that forces you to work against the gravitational force, including weight lifting, running, walking, aerobics, soccer, basketball or gymnastics will contribute towards the peak bone mass. These exercises put stress on bones making them tougher by adding tissue through formation. However too much of physical activity or exercising can result in declining estrogen levels, amenorrhea and eventually bone loss in women.
Chronic disorders that result in excessive resorption can reduce peak bone mass. Health conditions like hyperthyroidism, certain cancers, chronic liver disease, rheumatoid arthritis, and mala absorptive disorders can also negatively impact the peak bone mass in women. Certain drugs like thyroid hormone or glucocorticoids can also lead to bone loss. Women take thyroid hormone during therapy for an underactive thyroid gland while glucocorticoids are taken to control asthma, immune disorders, and other diseases.
Medications used to treat breast cancer and prostate cancers are also believed to have some impact on the peak bone mass. People who have undergone organ transplant are usually given several drugs to speed bone loss are at a higher risk of developing osteoporosis due to low bone mass.
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