Puberty and Bone Health in Chronic Disease

Linear growth, onset of and progress through puberty are all adversely affected by chronic diseases during childhood and adolescence. Peak bone mass accrual by the end of adolescence determines adult fracture risk. Given that half of total lifetime bone mass is accrued during the pubertal years under the influence of sex hormones, normal timing of pubertal onset, with attention to completion of feminization for girls or virilization in boys is integral to achievement of optimal bone mass, which in turn will reduce adult fracture risk for those who have a chronic relapsing, remitting or persistent illness.