DESCRIPTION (provided by applicant): Osteoporosis is a major public health problem affecting over 10 million adults, primarily women. A key contributor to osteoporosis prevention is optimizing accrual of peak bone mass. Adolescence is a dynamic period for bone mass development as nearly 50% of mass is accrued primarily around puberty. Smoking, alcohol, &depression can negatively influence bone mass. Experimentation with substances begins and escalates in adolescence and in those more vulnerable, detrimental effects on health can occur across the lifespan. Depression also increases. There are differential rates and/or morbidity-mortality consequences by gender for substance use and depression with girls being more affected than boys. Compared to men, adult women have more difficulty in smoking cessation, are more likely to experience depression in cessation, and are more sensitive to negative consequences of alcohol. Further, depression is also linked with osteoporosis or low bone mass more so in women. No studies in adolescence have examined effects of substance use and depression on metabolic consequences, such as bone health. The R21 proposes to examine such issues in a biobehavioral conceptual model. Secondary analysis will be conducted in 264 girls (11-17 years) enrolled in a cross-sequential study for 3 annual visits (Dorn;PI;R01 DA16402). The sample reflects diversity in race/ethnicity (African-American 31.1%;Caucasian 63.3%) and social class. Retention is >90%. We include examination of alcohol use and analysis of frozen samples for cytokine activity and other hormones. Unique aims were added to examine the stress system and systemic inflammatory responses (cytokine activity) as potential mechanisms explaining the relationship of depression and substance use with bone health (bone mineral content). Aims are: (1) To examine characteristics of individual differences in developmental trajectories of bone health across 3 years by alcohol status. (2) To examine contextual effects of smoking and alcohol on the mediating pathway of stress system (HPA axis) activity on the relationship between symptoms of depression/anxiety and individual differences in developmental trajectories of bone health across 3 years. (3) To examine contextual effects of smoking and alcohol on the mediating pathway of the systemic inflammatory response (serum cytokine activity) on the relationship between depression/anxiety and individual differences in developmental trajectories of bone health across 3 years. Examining the impact of these factors has import for future intervention and prevention strategies in adolescence. The pathway to osteoporosis is multifactorial and begins early in life. Substance use and depression in adolescence may have long-term consequences for bone health (i.e. >risk of osteoporotic fracture). PUBLIC HEALTH RELEVANCE: Osteoporosis is a major public health problem. The pathway to osteoporosis is multifactorial and begins early in life. Puberty is a dynamic period of development for optimal bone accrual and a critical time where substance use and mental health problems emerge. We propose to examine the combined impact of timing of puberty, substance use, and depression/anxiety on bone health in adolescent girls. Focusing on the potential mechanism involved in this relationship including stress system hormones and cytokines, may enhance intervention and prevention efforts for poor bone health.
|Effective start/end date||5/15/09 → 4/30/11|
- National Institutes of Health: $187,500.00
- National Institutes of Health: $225,000.00
Bone and Bones