New research on sex hormones and children’s bone health

Researcher and pediatric endocrinologist Jovanna Dahlgren emphasizes that bone health depends on several combined factors, with physical activity, vitamin D, and balanced nutrition playing central roles. Sex hormones also have a significant impact, especially during childhood and adolescence.

“At various health conditions in childhood, sex hormones may be altered, which can lead to reduced bone mineralization. Because prepubertal children have very low levels of sex hormones, ultra-sensitive analytical instruments are required to detect small changes in these individuals,” says Jovanna Dahlgren, professor of pediatric endocrinology and Head of Institute at the Institute of Clinical Sciences, University of Gothenburg.

Essential technical equipment

The new grant of 3.9 million SEK from the IngaBritt and Arne Lundberg Research Foundation enables the purchase of a new generation LC-mass spectrometer (LC-MS). This technology is crucial for measuring the extremely low hormone levels in children. The instrument is not only faster than previous methods – its breakthrough lies in the ability to analyze up to 30 different steroid hormones in a single measurement, instead of only estrogen and testosterone.

I’m incredibly happy and grateful for this grant. It allows us to acquire instruments that open entirely new possibilities for our research.

“We have been leaders in analyzing sex steroids in children since the mid-1990s. Now technology has caught up, and the ultra-sensitive LC-MS method gives us a unique opportunity to study the entire enzymatic cascade of steroid synthesis. It helps us map how the various hormones interact and affect, for example, the development of abdominal obesity in risk groups such as preterm or growth-restricted children,” says Jovanna Dahlgren.

Multidisciplinary collaboration and social benefit

The research is multidisciplinary and involves collaboration with gynecologists, orthopaedists, and bariatric surgeons. The project includes four unique studies, among them a prospective cohort of more than 2,600 children in Halland followed since birth. This population-based group of teenagers can now be examined for bone health with spinal MRI to identify factors most important for low bone mineralization. A key focus is to study bone health in risk groups such as preterm children, those small for gestational age, and adolescents with severe obesity.

Together with gynecologists, the team will study young women with polycystic ovaries – their hormone patterns and body composition. In adolescents with severe obesity, researchers are examining the long-term effects of weight-loss surgery. Previous findings show that those with somewhat low bone mineralization before surgery are at high risk of further loss afterward. It is known that sex hormones change rapidly after surgery, as does insulin sensitivity. By integrating hormone analysis, the researchers hope to identify individuals at increased risk.

Studying links to obesity and ADHD

The group also investigates possible long-term risks, including connections between obesity, ADHD, and a potentially increased risk of addiction after surgery.

“The goal is to develop tailored preventive measures to ensure that treatment leads only to benefit – not unwanted effects such as impaired bone health. For example, treatment of severe obesity in youth through bariatric surgery raises ethical questions similar to the debate on gender dysphoria – how early to intervene before adulthood. I emphasize the importance of following ethical guidelines and regulatory approvals to ensure that research and new treatments are carried out with the greatest possible care,” says Jovanna Dahlgren.

Beyond medical advances, the research also offers clear socioeconomic benefits.

“Sweden has an unusually high risk of osteoporosis, and if we can optimize bone mineralization in childhood, we can lay the foundation for healthier aging. By identifying risk groups early and implementing preventive actions against abdominal obesity and poor bone quality, society can save considerable future costs – avoiding expenses for healthcare and early retirement while reducing suffering for individuals.”

Text: Lundberg Foundation