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Use of stimulant drugs may reduce bone mass in children, adolescents

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BOSTON — Children who use stimulant medications — first-line medical therapy for attention-deficit/hyperactivity disorder in the United States — may be at risk for lower bone mineral density, according to a presenter here.

Alexis Jamie Feuer, MD, a pediatric endocrinologist at Weill Cornell Medicine New York Presbyterian, and colleagues conducted a cross-sectional analysis of data on 6,489 children aged 8 to 20 years (mean age, 13.58) enrolled in the National Health and Nutrition Examination Survey 2005-2010. Participants had complete demographic, DXA, anthropometric and medication use data available; 159 reported using stimulant drugs and no other medications.

Alexis Jamie Feuer

After multivariable adjustments for age, sex, height and weight z score, socioeconomic status, physical activity, tobacco exposure and race/ethnicity, researchers found that stimulant use was an independent predictor of bone mass. At the lumbar spine, bone mineral content was 5.1% lower among stimulant users than among non-users (13.17 vs. 13.87 g; P = .005), and BMD was 3.9% lower (0.92 vs. 0.95 g/cm²; P = .002). Femoral neck bone mineral content and total femur BMD were also lower in stimulant users vs. non-users (bone mineral content: 4.34 vs. 4.59 g, P = .03; total femur BMD: 0.94 vs. 0.99 g/cm², P = .05).

Longer duration of treatment (more or less than 6 months) was also associated with lower BMD and bone mineral content of the lumbar spine and total femur BMD in stimulant users vs. non-users.

“Our research shows that children and teens taking stimulants have lower bone density than their peers, which puts them at risk for future osteoporosis,” Feuer told Endocrine Today. “Clinicians caring for these kids should begin regular screening for bone health by monitoring for appropriate linear growth and weight gain, as well as making sure they are getting enough weight-bearing exercise and Vitamin D.” – by Jill Rollet

Reference:

Feuer AJ, et al. OR01-5. Presented at: The Endocrine Society Annual Meeting; April 1-4, 2016; Boston.

Disclosure: Feuer reports no relevant financial disclosures.