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Multicenter Study
. 2014 Jun;164(6):1280-5.e2.
doi: 10.1016/j.jpeds.2013.12.040. Epub 2014 Jan 30.

Longitudinal tracking of dual-energy X-ray absorptiometry bone measures over 6 years in children and adolescents: persistence of low bone mass to maturity

Tishya A L Wren  1 , Heidi J Kalkwarf  2 , Babette S Zemel  3 , Joan M Lappe  4 , Sharon Oberfield  5 , John A Shepherd  6 , Karen K Winer  7 , Vicente Gilsanz  8 ; Bone Mineral Density in Childhood Study Group
Collaborators, Affiliations
Multicenter Study

Longitudinal tracking of dual-energy X-ray absorptiometry bone measures over 6 years in children and adolescents: persistence of low bone mass to maturity

Tishya A L Wren et al. J Pediatr. 2014 Jun.

Abstract

Objectives: Early assessment of bone mass may be useful for predicting future osteoporosis risk if bone measures "track" during growth. This prospective longitudinal multicenter study examined tracking of bone measures in children and adolescents over 6 years to sexual and skeletal maturity.

Study design: A total of 240 healthy male and 293 healthy female patients, ages 6-17 years, underwent yearly evaluations of height, weight, body mass index, skeletal age, Tanner stage, and dual-energy x-ray absorptiometry (DXA) bone measurements of the whole body, spine, hip, and forearm for 6 years. All subjects were sexually and skeletally mature at final follow-up. Correlation was performed between baseline and 6-year follow-up measures, and change in DXA Z-scores was examined for subjects who had baseline Z < -1.5.

Results: DXA Z-scores (r = 0.66-0.87) had similar tracking to anthropometric measures (r = 0.64-0.74). Tracking was stronger for bone mineral density compared with bone mineral content and for girls compared with boys. Tracking was weakest during mid- to late puberty but improved when Z-scores were adjusted for height. Almost all subjects with baseline Z < -1.5 had final Z-scores below average, with the majority remaining less than -1.0.

Conclusions: Bone status during childhood is a strong predictor of bone status in young adulthood, when peak bone mass is achieved. This suggests that bone mass measurements in children and adolescents may be useful for early identification of individuals at risk for osteoporosis later in life.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Correlation between baseline and final (6-year) Z-scores for whole body less head BMC as a function of baseline Tanner stage. Similar trends were observed for other DXA bone measures.
Figure 2
Figure 2
Mean ± SD whole body less head BMC Z-scores over time for subjects subdivided by baseline Z-score (<−1.5, −1.5 to 1.5, >1.5). Final Z-scores differed significantly among the different baseline groups (p < 0.001).
Figure 3
Figure 3
Change between baseline and final (6-year) Z-scores for whole body less head BMC subdivided by baseline Z-score: > 1.5 (top row), −1.5 to 1.5 (middle row), < −1.5 (bottom row). Similar trends were observed for other DXA bone measures.
Figure 4
Figure 4
Final height-adjusted Z-scores for subjects starting with adjusted Z < −1.5 at baseline.
See this image and copyright information in PMC

Comment in

References

    1. Gilsanz V, Perez FJ, Campbell PP, Dorey FJ, Lee DC, Wren TA. Quantitative CT reference values for vertebral trabecular bone density in children and young adults. Radiology. 2009;250:222–7. - PMC - PubMed
    1. Gilsanz V, Kovanlikaya A, Costin G, Roe TF, Sayre J, Kaufman F. Differential effect of gender on the size of the bones in the axial and appendicular skeletons. J Clin Endocrinol Metab. 1997;82:1603–7. - PubMed
    1. Gilsanz V, Roe TF, Mora S, Costin G, Goodman WG. Changes in vertebral bone density in black girls and white girls during childhood and puberty. N Engl J Med. 1991;325:1597–600. - PubMed
    1. Burrows M, Baxter-Jones A, Mirwald R, Macdonald H, McKay H. Bone mineral accrual across growth in a mixed-ethnic group of children: are Asian children disadvantaged from an early age? Calcif Tissue Int. 2009;84:366–78. - PubMed
    1. Clarke BL, Khosla S. Female reproductive system and bone. Arch Biochem Biophys. 2010;503:118–28. - PMC - PubMed

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