Commentary on "Pediatric and adult osteoporosis: a contrasting mirror"

Article information

Ann Pediatr Endocrinol Metab. 2025;30(1):55-56

Publication date (electronic) : 2025 February 28

doi : https://doi.org/10.6065/apem.2448244.122

Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea

Address for correspondence: Yoon-Sok Chung Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164 Worldcup-ro Yeoungtong-gu, Suwon 16499, Korea Email: yschung@ajou.ac.kr

Received 2024 September 16; Accepted 2025 February 6.

To the editor,

I read the review paper entitled "Pediatric and adult osteoporosis: a contrasting mirror [1]." I have some comments to the editor and authors in the areas of osteoporosis in children and adults.

Agreements and supports

For the diagnosis of osteoporosis, fragility fracture rather than bone mineral density (BMD) is important sign of osteoporosis in both children and adults. I agree with the authors' opinion for diagnosis of osteoporosis in children as follows. The subjects with one of the following criteria; (1) Vertebral fragility compression fracture, (2) fracture and z-score equal or less than -2.0, (3) 2 or more long bone fractures by age 10 years, (4) 3 or more long bone fractures by age 19 years.

Each country or ethnicity is recommended to have their own BMD data and guideline for diagnosis and treatment of osteoporosis not only in adults but also in children. For example, clinical practice guideline for bone health in Korean children and adolescents has been published [2]. Korean normative data for children BMD are available for lumbar spine, femoral neck, total body, total body less head areas [3,4].

Suggestions for corrections

The authors may need to correct or clarify the adult dosages of the bisphosphonates in the Table 1. Osteoporosis treatment dose of intravenous pamidronate in adult is usually 30–90 mg per every 3–4 months (90 mg every 4 weeks is usually cancer bone metastasis osteolysis treatment dose) [5]. Osteoporosis treatment dose of oral alendronate in adult is 70 mg/wk (not 35 mg/wk) [6].

Notes

Conflicts of interest

No potential conflict of interest relevant to this article was reported.

References

1. Ferjani HL, Cherif I, Nessib DB, Kaffel D, Maatallah K, Hamdi W. Pediatric and adult osteoporosis: a contrasting mirror. Ann Pediatr Endocrinol Metab 2024;29:12–8.

2. Lee YA, Kwon A, Kim JH, Nam HK, Yoo JH, Lim JS, et al. Clinical practice guidelines for optimizing bone health in Korean children and adolescents. Ann Pediatr Endocrinol Metab 2022;27:5–14.

3. Lim JS, Hwang JS, Lee JA, Kim DH, Park KD, Cheon GJ, et al. Bone mineral density according to age, bone age, and pubertal stages in Korean children and adolescents. J Clin Densitom 2010;13:68–76.

4. Yi KH, Hwang JS, Kim EY, Lee JA, Kim DH, Lim JS. Reference values for bone mineral density according to age with body size adjustment in Korean children and adolescents. J Bone Miner Metab 2014;32:281–9.

5. Kim JH, Jeong HE, Baek YH, Cho SW, Lim H, Shin JY. Treatment pattern in postmenopausal women with osteoporosis: a population-based cohort study in South Korea. J Bone Miner Metab 2022;40:109–19.

6. Watts NB. Treatment of osteoporosis with bisphosphonates. Rheum Dis Clin North Am 2001;27:197–214.

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