Disorders of calcium and phosphorus metabolism in adolescents.

During adolescence, there are marked changes in the metabolism of calcium and phosphorus and a dramatic increase in the rate of bone mineralization under the influence of the sex hormones, growth hormone, and insulin-like growth factor-1. More than 50% of adult bone mass is accumulated during puberty; failure to achieve maximum bone mineralization at this time may lead to osteopenia and its complications in later adulthood. This article discusses the causes, evaluation, and management of adolescents with hypocalcemia, hypercalcemia, and disorders of bone mineralization.