Session: OR01-Osteoporosis: What You Had, What You Lost, and What You Gain
Room 157 (BCEC)
Outstanding Abstract Award
Objective: To investigate associations between stimulant use and bone mass in pediatric subjects.
Design: Cross-sectional analysis of data from the 2005–2010 National Health and Nutrition Examination Study (NHANES).
Participants: 6489 NHANES participants ages 8–20 years (mean 13.58 + 3.58).
Outcomes: Total femur, femoral neck and lumbar spine bone mineral content (BMC) and density (BMD) assessed via dual-energy X-ray absorptiometry (DXA).
Results: 159 of 6489 subjects used stimulants. Stimulant use was an independent predictor of bone mass after multivariable adjustment for age, gender, height and weight Z score, socioeconomic status, physical activity, cotinine level and race/ethnicity. Lumbar spine BMC was 5.1% lower among stimulant users versus non-users (mean difference 0.704 g, SE ± 0.02 g, p = 0.005). Lumbar spine BMD was 3.9% lower (mean difference 0.037 g/cm2, SE ± 0.001 g/cm2, p = 0.002). Femoral neck BMC was similarly negatively associated with stimulant use while BMD approached significance. Compared to nonusers, femoral neck BMC was 5.3% lower among stimulant users (mean difference 0.242 g, SE ± 0.0093 g, p = 0.009) and BMD was 3.7% lower (mean difference 0.034 g/cm2, SE ± 0.0157 g/cm2, p = 0.08). Subjects treated with stimulants for more than 6 months had lower lumbar spine BMD and BMC than those using for less than six months and non-users.
Conclusion: In this NHANES study, pediatric subjects treated with stimulants had lower DXA measurements of the lumbar spine and femoral neck compared to non-users. As stimulant medications are first-line pharmacotherapies for ADHD, their potential effects on pediatric bone health need to be clarified. These findings support the need for future prospective studies to examine the effects of stimulant use on bone mass in this population.
Disclosure: MGV: Advisory Group Member, Novo Nordisk. Nothing to Disclose: AJF, AT, RTD
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