title: Underweight, overweight, and pediatric bone fragility: impact and management.
abstract: Skeletal health is modulated by a variety of factors, including genetic makeup, hormonal axes, and environment. Across all ages, extremes of body weight may exert a deleterious effect on bone accretion and increase fracture risk. The incidence of both anorexia nervosa and obesity, each involving extreme alterations in body composition, is rising among youth, and secondary osteoporosis is increasingly being diagnosed among affected children and adolescents. Compared with the elderly, the definition of osteoporosis that stems from any underlying condition differs for the pediatric population and special precautions are required with regard to treatment of young patients. Early recognition and management of both underweight and overweight youth and the accompanying consequences on bone and mineral metabolism are essential for preservation of skeletal health, although prevention of bone loss and optimization of bone mineral accrual remain the most important protective measures.
authors.affiliation: Division of Pediatric Endocrinology, Hasbro Children's Hospital/Alpert Medical School of Brown University, 593 Eddy Street, MPSII, Providence, RI, 02903, USA, sbialo@lifespan.org.
authors.forename: Shara R
authors.initials: SR
authors.lastname: Bialo
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Gordon
mesh_terms: D000293:Adolescent; D000856:Anorexia Nervosa / Q000150:complications*; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D002648:Child; D004164:Diphosphonates / Q000627:therapeutic use; D005081:Exercise Therapy; D006801:Humans; D009765:Obesity / Q000150:complications*; D010024:Osteoporosis / Q000209:etiology* / Q000628:therapy; D050177:Overweight / Q000150:complications; D019379:Teriparatide / Q000627:therapeutic use; D013851:Thinness / Q000150:complications*; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D019379:Teriparatide; D014807:Vitamin D