Centile curves for bone densitometry measurements in healthy males and females ages 5-22 yr

Normative pediatric bone measurement data are necessary for defining osteopenia in children and for identifying factors associated with normal bone growth. The LMS statistical method is used to produce centile curves plotting a growth characteristic as a function of age. The purpose of this study was to provide centile curves of bone measurements using peripheral quantitative computed tomography (pQCT) and dual X-ray absorptiometry (DXA) in 231 (107 male) healthy individuals ages 5-22 yr using the LMS method. pQCT (Norland XCT 2000; Norland, Ft. Atkinson, WI) was used to image a single slice at the 20% distal tibia. Periosteal circumference, endosteal circumference, and cortical density measurements were used to obtain centile curves. Whole-body DXA (Hologic QDR 4500; Hologic, Bedford, MA) was obtained and scans were analyzed using adult whole-body software for total body bone mineral content (BMC) and total body bone area. pQCT measurements showed prepubertal expansion of the tibia that plateaued in females at age 14 and continued in males until age 18. Tibia cortical density increased during the age of puberty more gradually in females than in males. DXA measurement curves showed that total body BMC and total body bone area plateaued in females at approximately age 15, whereas male curves of the same measurements showed a continued increase.