International longitudinal pediatric reference standards for bone mineral content

被引:31
作者
Baxter-Jones, Adam D. G. [2 ]
Burrows, Melonie [4 ]
Bachrach, Laura K. [5 ]
Lloyd, Tom [6 ]
Petit, Moira [7 ]
Macdonald, Heather [8 ]
Mirwald, Robert L. [2 ]
Bailey, Don [2 ,9 ]
McKay, Heather [1 ,3 ,4 ]
机构
[1] Univ British Columbia, Vancouver Coastal Hlth Res Inst, Fac Med, Dept Orthopaed,Willow Chest Ctr, Vancouver, BC V5Z 3P1, Canada
[2] Univ Saskatchewan, Coll Kinesiol, Saskatoon, SK S7N 0W0, Canada
[3] Univ British Columbia, Vancouver Coastal Hlth Res Inst, Dept Family Practice, Vancouver, BC V5Z 3P1, Canada
[4] Univ British Columbia, Vancouver Coastal Hlth Res Inst, Ctr Hip Hlth & Mobil, Vancouver, BC V5Z 3P1, Canada
[5] Stanford Univ, Sch Med, Stanford, CA 94305 USA
[6] Milton S Hershey Med Ctr, Dept Publ Hlth Sci, Hershey, PA USA
[7] Univ Minnesota, Sch Kinesiol, Minneapolis, MN USA
[8] Univ Calgary, Dept Mech & Mfg Engn, Calgary, AB, Canada
[9] Univ Queensland, Sch Human Movement Studies, Brisbane, Qld 4072, Australia
关键词
Children; DXA; Growth; Maturation; Z-score; ADOLESCENT GROWTH SPURT; PHYSICAL-ACTIVITY; HEALTHY-CHILDREN; FEMORAL-NECK; TOTAL-BODY; DENSITY; MASS; DENSITOMETRY; STRENGTH; SPINE;
D O I
10.1016/j.bone.2009.10.017
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
To render a diagnosis pediatricians rely upon reference standards for bone mineral density or bone mineral content, which are based on cross-sectional data from a relatively small sample of children. These standards are unable to adequately represent growth in a diverse pediatric population. Thus, the goal of this study was to develop sex and site-specific standards for BMC using longitudinal data collected from four international sites in Canada and the United States. Data from four studies were combined; Saskatchewan Paediatric Bone Mineral Accrual Study (n=251), UBC Healthy Bones Study (n=382); Penn State Young Women's Health Study (n=112) and Stanford's Bone Mineral Accretion study (n=423). Males and females (8 to 25 years) were measured for whole body (WB), total proximal femur (PF), femoral neck (FN) and lumbar spine (IS) BMC (g). Data were analyzed using random effects models. Bland-Altman was used to investigate agreement between predicted and actual data. Age, height, weight and ethnicity independently predicted BMC accrual across sites (P<0.05). Compared to White mates, Asian males had 31.8 (6.8) g less WB BMC accrual; Hispanic 75.4 (28.2) g less BMC accrual; Blacks 82.8 (26.3) g more BMC accrual with confounders of age, height and weight controlled. We report similar findings for the PF and FN. Models for females for all sites were similar with age, height and weight as independent significant predictors of BMC accrual (P<0.05). We provide a tool to calculate a child's BMC Z-score, accounting for age, size, sex and ethnicity. In conclusion, when interpreting BMC in pediatrics we recommend standards that are sex, age, size and ethnic specific. (C) 2009 Elsevier Inc. All rights reserved.
引用
收藏
页码:208 / 216
页数:9
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