Longitudinal Impact of Substance Use and Depressive Symptoms on Bone Accrual Among Girls Aged 11–19 Years
Open accessAbstract
Purpose Osteoporosis is primarily evident in postmenopausal women, but its roots are traceable to periods of growth, including during adolescence. Depression, anxiety, and smoking are associated with lower bone mineral density (BMD) in adults. These associations have not been studied longitudinally across adolescence, when more than 50% of bone accrual occurs.Methods To determine the impact of depressive and anxiety symptoms, smoking, and alcohol use on bone accrual in girls 11-19 years, 262 healthy girls were enrolled in age cohorts of 11, 13, 15, and 17 years. Using a cross-sequential design, girls were seen for three annual visits. Outcome measures included total body bone mineral content and BMD of the total hip and lumbar spine using dual energy x-ray absorptiometry. Depressive and anxiety symptoms and smoking and alcohol use were by self-report.Results Higher-frequency smoking was associated with a lower rate of lumbar spine and total hip BMD accrual from ages 13-19. Higher depressive symptoms were associated with lower lumbar spine BMD across 11-19 years of age. There was no effect of depressive symptoms on total body bone mineral content, and there was no effect of alcohol intake on any bone outcome.Conclusion Adolescent smokers are at higher risk for less than optimal bone accrual. Even in the absence of diagnosable depression, depressive symptoms may influence adolescent bone accrual. These findings have import for prevention of later osteoporosis and fractures.
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Two other studies reported similar findings regarding a lack of effect for alcohol use on BMD.
“Two other studies reported similar findings regarding a lack of effect for alcohol use on BMD [81, 82].”
From The Effect of Tobacco Smoking on Bone Mass: An Overview of Pathophysiologic Mechanisms (2018) · cites this paper as [82]
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Self-citation
- Authors
- Dorn, L. D., Beal, S. J., Kalkwarf, H. J., Pabst, S., Noll, J. G., & Susman, E. J.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- Pennsylvania State University (US)
- Corresponding author
- Dorn, Lorah D.
- Venue
- Journal of Adolescent Health
- Publisher
- Elsevier BV
- Published
- 2013-04
- Volume
- 52
- Issue
- 4
- Pages
- 393-399
- ISSN
- 1054-139X (ISSN-L)
- PMC
- PMC3608731
- OpenAlex
- W2054472095
- Cited by
- 40
- References
- 44
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2021: 3 · 2020: 4 · 2019: 3 · 2018: 4 · 2017: 3 · 2016: 4 · 2015: 5 · 2014: 6 · 2013: 4
- FWCI
- 5.13
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Adolescent Health (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Health and Human Services (T32HP10027)
- National Institutes of Health (T32HP10027, 5ul1rr026314-03, UL1TR000077, UL1 RR-026314)
- Health Resources and Services Administration (T32 HP10027)
- U.S. Public Health Service (#UL1 RR026314, T32 HP10027)
- National Institute on Drug Abuse (R01DA016402, R01DA16402)
- National Center for Research Resources (UL1-RR026314)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Orthopedics and Sports Medicine › Bone health and osteoporosis research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Bone Metabolism and Diseases
- Social Sciences › Arts and Humanities › Archeology › Forensic Anthropology and Bioarchaeology Studies
- Keywords
- bone accrual, adolescent girls, depressive symptoms, anxiety symptoms, adolescent smoking, alcohol consumption, bone mineral density, osteoporosis prevention, lumbar spine, total hip, bone mineral content, adolescence
- MeSH terms
- Adolescent, Alcohol Drinking, Anxiety Disorders, Calcium, Dietary, Child, Depressive Disorder, Female, Humans, Longitudinal Studies, Motor Activity, Osteoporosis, Risk Factors, Smoking, Vitamin D, Cohort Studies, Absorptiometry, Photon, Bone Density
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