BACKGROUND Puberty is a critical period for bone mass accrual, and late puberty in boys is associated with reduced bone mass in adult men. The role of variations in pubertal timing within the normal range for adult fracture risk in men is, however, unknown. We, therefore, assessed the association between age at peak height velocity (PHV), an objective measure of pubertal timing, and fracture risk in adult men. METHODS AND FINDINGS In the BMI Epidemiology Study Gothenburg, 31,971 Swedish men born between January 1, 1945, and December 31, 1961, with detailed growth data (height and weight) available from centrally archived school healthcare records and the conscription register were followed until December 31, 2016. Age at PHV was calculated according to a modified infancy-childhood-puberty model, and fracture information was retrieved from the Swedish National Patient Register. The mean ± SD age at PHV was 14.1 ± 1.1 years. In total, 5,872 men (18.4%) sustained at least 1 fracture after 20 years of age and 5,731 men (17.9%) sustained a non-vertebral fracture after 20 years of age during a mean ± SD follow-up of 37.3 ± 11.7 years. Cox proportional hazards models adjusted for birth year and country of origin revealed that age at PHV was associated with the risk of any fracture and non-vertebral fracture. Participants with age at PHV in the highest tertile (after 14.5 years of age) were at greater risk of any fracture (hazard ratio [HR] 1.15, 95% confidence interval [CI] 1.08-1.22, P < 0.001) and non-vertebral fracture (HR 1.16, 95% CI 1.09-1.24, P < 0.001) compared with those with age at PHV in the lowest tertile (at 13.6 years of age or younger). Additional adjustments for birthweight, childhood BMI, adult educational level, and young adult height did not attenuate the associations between age at PHV and adult fracture risk. Limitations of this study include the inability to adjust for important risk factors for fracture, inadequate power to assess the relation between pubertal timing and specific fracture types, and the limited generalizability to other populations. CONCLUSIONS In this study, we observed that late pubertal timing was associated with increased adult fracture risk in men. These findings suggest that information on pubertal timing might aid in the identification of those men at greatest risk of fracture.

中文翻译：

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男性青春期时机和成人骨折风险：一项基于人群的队列研究。

背景技术青春期是骨质积聚的关键时期，男孩中的青春期晚期与成年男性的骨质减少有关。然而，在男性正常成人骨折风险的正常范围内，青春期时机变化的作用尚不清楚。因此，我们评估了成年男性的峰值高度速度（PHV）年龄，青春期时机的客观测量与骨折风险之间的关联。方法和发现在哥德堡的BMI流行病学研究中，有31,971名瑞典人，出生于1945年1月1日至1961年12月31日之间，其详细的生长数据（身高和体重）可从中央存档的学校医疗记录中获得，并且应征兵登记册被追踪到12月。 2016年3月31日。PHV年龄是根据改良的婴儿期-青春期-青春期模型计算得出的，从瑞典国家病人登记簿中检索骨折信息。PHV的平均±SD年龄为14.1±1.1岁。总共有5872名男性（18.4％）在20岁以后至少发生了一次骨折，而5731名男性（17.9％）在20岁以后发生了非椎骨骨折，平均±SD随访为37.3±11.7年。对出生年份和原产国进行调整的Cox比例风险模型显示，PHV的年龄与任何骨折和非椎骨骨折的风险有关。PHV年龄最高的参与者（在14.5岁之后）患任何骨折的风险更高（危险比[HR] 1.15，95％置信区间[CI] 1.08-1.22，P <0.001）和非椎骨骨折（HR 1.16，95％CI 1.09-1.24，P <0.001）与最低年龄（13岁）的PHV年龄相比。6岁以下）。出生体重，儿童BMI，成人教育水平和年轻成年人身高的其他调整并不能减弱PHV年龄与成人骨折风险之间的关联。该研究的局限性包括无法调整重要的骨折危险因素，评估青春期时机与特定骨折类型之间关系的能力不足以及对其他人群的局限性。结论在这项研究中，我们观察到青春期的后期与男性成人骨折风险的增加有关。这些发现表明，有关青春期时机的信息可能有助于确定那些骨折风险最高的男性。而年轻的成年人身高并不能减弱PHV年龄与成人骨折风险之间的联系。该研究的局限性包括无法调整重要的骨折危险因素，评估青春期时机与特定骨折类型之间关系的能力不足以及对其他人群的局限性。结论在这项研究中，我们观察到青春期的后期与男性成人骨折风险的增加有关。这些发现表明，有关青春期时机的信息可能有助于确定那些骨折风险最高的男性。而年轻的成年人身高并不能减弱PHV年龄与成人骨折风险之间的关联。这项研究的局限性包括无法调整重要的骨折危险因素，评估青春期时机与特定骨折类型之间关系的能力不足以及对其他人群的局限性。结论在这项研究中，我们观察到青春期后期与男性成人骨折风险增加有关。这些发现表明，有关青春期时机的信息可能有助于确定那些骨折风险最高的男性。以及对其他人群的通用性有限。结论在这项研究中，我们观察到青春期后期与男性成人骨折风险增加有关。这些发现表明，有关青春期时机的信息可能有助于确定那些骨折风险最高的男性。以及对其他人群的通用性有限。结论在这项研究中，我们观察到青春期后期与男性成人骨折风险增加有关。这些发现表明，有关青春期时机的信息可能有助于确定那些骨折风险最高的男性。