Girls who smoke at risk for osteoporosis

Adolescent girls who are frequent smokers are at increased risk for osteoporosis in the lumbar spine and hips as they age, according to new research on the effect of substance use on bone development in teenaged girls.

Investigators focused on girls aged 11 to 19 years because more than half of adult bone accrual occurs during adolescence.

The study at Cincinnati Children’s Hospital Medical Center enrolled 262 healthy girls in age cohorts of 11, 13, 15, and 17 years. They received annual clinical examinations over 3 years and were measured by dual energy x-ray absorptiometry for total body bone mineral content and bone mineral density of the lumbar spine and total hip, both areas susceptible to fracture in older women with osteoporosis. The girls self-reported how often they smoked and used alcohol and also any symptoms of depression or anxiety.

The researchers found that girls aged 13 to 19 years who smoked most frequently had lower lumbar spine and total hip bone mineral density accrual than girls who smoked less. Higher depression symptoms were associated with lower lumbar spine bone mineral density for all participants. Depression had no effect on total body bone mineral content, nor did alcohol use affect any bone outcome.

Studies in adults have shown an association between smoking and osteoporosis and risk of bone fracture. The researchers say that their findings are the first to confirm the negative impact of smoking and depression on adolescent girls’ bone development during the most critical years for bone accrual.