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The developmental origins of osteoporotic fracture

Nicholas Harvey1, Cyrus Cooper

  • 1MRC Environmental Epidemiology Unit, Southampton General Hospital, Southampton SO16 6YD, UK.

The Journal of the British Menopause Society
|April 27, 2004
PubMed

Insights

Early life nutrition and growth impact adult bone health, influencing the risk of osteoporotic fractures. Understanding fetal and infant development is key to preventing osteoporosis later in life.

Area of Science:

  • Bone biology and metabolism
  • Developmental origins of health and disease (DOHaD)

Background:

  • Early life undernutrition and adverse influences permanently affect body structure, physiology, and metabolism.
  • Growing evidence links fetal and infant programming of bone growth to later osteoporotic fracture risk.

Purpose of the Study:

  • To review the evidence on early life influences on bone development and their long-term impact on osteoporotic fracture risk.
  • To highlight the role of infant body weight, growth hormone/insulin-like growth factor-1 (GH/IGF-1) axis, hypothalamic-pituitary-adrenal (HPA) axis, and vitamin D in bone programming.

Main Methods:

  • Review of human epidemiological and observational studies.
  • Analysis of factors including maternal nutrition, smoking, infant body weight, childhood growth rates, and hormonal axes.

Main Results:

  • Maternal factors (smoking, nutrition) influence intrauterine skeletal mineralization.
  • Infant body weight affects adult bone mineral content and activity of GH/IGF-1 and HPA axes.
  • Childhood growth rates are directly associated with later hip fracture risk.

Conclusions:

  • Early life factors significantly program bone development, contributing to adult osteoporotic fracture risk.
  • Further research is needed to develop novel therapeutic and preventative strategies targeting early life interventions to reduce osteoporosis burden.

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