Bone Mass, Depressive, and Anxiety Symptoms in Adolescent Girls: Variation by Smoking and Alcohol Use

Overview

Journal J Adolesc Health

Publisher Elsevier

Specialty Pediatrics

Date 2011 Oct 25

PMID 22018564

Citations 15

Authors

Lorah D Dorn

Stephanie Pabst

Lisa M Sontag

Heidi J Kalkwarf

Jennifer B Hillman

Elizabeth J Susman

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of the study was to examine (a) the association between depressive and anxiety symptoms with bone health, (b) the association of smoking or alcohol use with bone health, and, in turn (c) whether the association between depressive and anxiety symptoms with bone health varied by smoking or alcohol use individually or by combined use. Bone health included total body bone mineral content (TB BMC) and bone mineral density (BMD) of the lumbar spine, total hip, and femoral neck. Previously published data have not examined these issues in adolescence, a period when more than 50% of bone mass is accrued.

Methods: An observational study enrolled 262 healthy adolescent girls by age cohort (11, 13, 15, and 17 years). Participants completed questionnaires and interviews on substance use, depressive symptoms, and anxiety. BMC and BMD were measured by dual-energy X-ray absorptiometry.

Results: Higher depressive symptoms were associated with lower TB BMC and BMD (total hip, femoral neck). Those with the lowest level of smoking had higher BMD of the hip and femoral neck, whereas no main effect differences were noted by alcohol use. Regular users of both cigarettes and alcohol demonstrated a stronger negative association between depressive symptoms and TB BMC as compared with nonusers/experimental users and regular alcohol users. Findings were parallel for anxiety symptoms.

Conclusion: Depressive and anxiety symptoms may negatively influence bone health in adolescent girls. Consideration of multiple substances, rather than cigarettes or alcohol separately, may be particularly informative with respect to the association of depression with bone health.

Citing Articles

Depression predicts decreased lumbar bone mineral density: A scoping review of chronic psychological stress and spinal tissue pathology.

Bucklin M, Gehrke E, Westrick J, Gottlieb M, Martin J Osteoarthr Cartil Open. 2024; 6(4):100529.

PMID: 39554478 PMC: 11565381. DOI: 10.1016/j.ocarto.2024.100529.

Osteoporosis and Bone Fragility in Children: Diagnostic and Treatment Strategies.

Cannalire G, Biasucci G, Bertolini L, Patianna V, Petraroli M, Pilloni S J Clin Med. 2024; 13(16).

PMID: 39201093 PMC: 11355204. DOI: 10.3390/jcm13164951.

Factors influencing peak bone mass gain.

Zhu X, Zheng H Front Med. 2020; 15(1):53-69.

PMID: 32519297 DOI: 10.1007/s11684-020-0748-y.

The Effect of Tobacco Smoking on Bone Mass: An Overview of Pathophysiologic Mechanisms.

Al-Bashaireh A, Haddad L, Weaver M, Chengguo X, Kelly D, Yoon S J Osteoporos. 2019; 2018:1206235.

PMID: 30631414 PMC: 6304634. DOI: 10.1155/2018/1206235.

The Effect of Tobacco Smoking on Musculoskeletal Health: A Systematic Review.

Al-Bashaireh A, Haddad L, Weaver M, Kelly D, Chengguo X, Yoon S J Environ Public Health. 2018; 2018:4184190.

PMID: 30112011 PMC: 6077562. DOI: 10.1155/2018/4184190.

References

Glastre C, Braillon P, David L, Cochat P, Meunier P, Delmas P . Measurement of bone mineral content of the lumbar spine by dual energy x-ray absorptiometry in normal children: correlations with growth parameters. J Clin Endocrinol Metab. 1990; 70(5):1330-3. DOI: 10.1210/jcem-70-5-1330. View

Dorn L, Susman E, Pabst S, Huang B, Kalkwarf H, Grimes S . Association of depressive symptoms and anxiety with bone mass and density in ever-smoking and never-smoking adolescent girls. Arch Pediatr Adolesc Med. 2008; 162(12):1181-8. PMC: 2660672. DOI: 10.1001/archpedi.162.12.1181. View

Hansen M, Overgaard K, Riis B, Christiansen C . Role of peak bone mass and bone loss in postmenopausal osteoporosis: 12 year study. BMJ. 1991; 303(6808):961-4. PMC: 1671323. DOI: 10.1136/bmj.303.6808.961. View

Marshall W, Tanner J . Variations in pattern of pubertal changes in girls. Arch Dis Child. 1969; 44(235):291-303. PMC: 2020314. DOI: 10.1136/adc.44.235.291. View

Crocker P, Bailey D, Faulkner R, Kowalski K, McGrath R . Measuring general levels of physical activity: preliminary evidence for the Physical Activity Questionnaire for Older Children. Med Sci Sports Exerc. 1997; 29(10):1344-9. DOI: 10.1097/00005768-199710000-00011. View

Wu Q, Liu J, Gallegos-Orozco J, Hentz J . Depression, fracture risk, and bone loss: a meta-analysis of cohort studies. Osteoporos Int. 2010; 21(10):1627-35. DOI: 10.1007/s00198-010-1181-x. View

Loud K, Gordon C . Adolescent bone health. Arch Pediatr Adolesc Med. 2006; 160(10):1026-32. DOI: 10.1001/archpedi.160.10.1026. View

Hopper J, Seeman E . The bone density of female twins discordant for tobacco use. N Engl J Med. 1994; 330(6):387-92. DOI: 10.1056/NEJM199402103300603. View

Mazess R, Barden H . Bone density in premenopausal women: effects of age, dietary intake, physical activity, smoking, and birth-control pills. Am J Clin Nutr. 1991; 53(1):132-42. DOI: 10.1093/ajcn/53.1.132. View

10.

Akhter M, Lund A, Gairola C . Bone biomechanical property deterioration due to tobacco smoke exposure. Calcif Tissue Int. 2005; 77(5):319-26. DOI: 10.1007/s00223-005-0072-1. View

11.

Korkor A, Eastwood D, Bretzmann C . Effects of gender, alcohol, smoking, and dairy consumption on bone mass in Wisconsin adolescents. WMJ. 2009; 108(4):181-8. View

12.

Costello E, Mustillo S, Erkanli A, Keeler G, Angold A . Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry. 2003; 60(8):837-44. DOI: 10.1001/archpsyc.60.8.837. View

13.

Jugdaohsingh R, OConnell M, Sripanyakorn S, Powell J . Moderate alcohol consumption and increased bone mineral density: potential ethanol and non-ethanol mechanisms. Proc Nutr Soc. 2006; 65(3):291-310. DOI: 10.1079/pns2006508. View

14.

Wezeman F, Emanuele M, Emanuele N, Moskal 2nd S, Woods M, Suri M . Chronic alcohol consumption during male rat adolescence impairs skeletal development through effects on osteoblast gene expression, bone mineral density, and bone strength. Alcohol Clin Exp Res. 1999; 23(9):1534-42. View

15.

Wosje K, Kalkwarf H . Bone density in relation to alcohol intake among men and women in the United States. Osteoporos Int. 2006; 18(3):391-400. DOI: 10.1007/s00198-006-0249-0. View

16.

Lauing K, Himes R, Rachwalski M, Strotman P, Callaci J . Binge alcohol treatment of adolescent rats followed by alcohol abstinence is associated with site-specific differences in bone loss and incomplete recovery of bone mass and strength. Alcohol. 2008; 42(8):649-56. PMC: 2633927. DOI: 10.1016/j.alcohol.2008.08.005. View

17.

Williams F, Cherkas L, Spector T, MacGregor A . The effect of moderate alcohol consumption on bone mineral density: a study of female twins. Ann Rheum Dis. 2004; 64(2):309-10. PMC: 1755353. DOI: 10.1136/ard.2004.022269. View

18.

Cizza G, Primma S, Coyle M, Gourgiotis L, Csako G . Depression and osteoporosis: a research synthesis with meta-analysis. Horm Metab Res. 2010; 42(7):467-82. PMC: 3120042. DOI: 10.1055/s-0030-1252020. View

19.

Lesusink G, Papapoulos S, Maartens L, Keyzer J, Weerdenburg J, Beijers L . The prevalence of low bone mineral density in Dutch perimenopausal women: the Eindhoven perimenopausal osteoporosis study. Osteoporos Int. 1998; 8(5):404-9. DOI: 10.1007/s001980050083. View

20.

Shaffer D, Fisher P, Lucas C, Dulcan M . NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): description, differences from previous versions, and reliability of some common diagnoses. J Am Acad Child Adolesc Psychiatry. 2000; 39(1):28-38. DOI: 10.1097/00004583-200001000-00014. View