TY - JOUR
T1 - International longitudinal pediatric reference standards for bone mineral content
AU - Baxter-Jones, Adam D.G.
AU - Burrows, Melonie
AU - Bachrach, Laura K.
AU - Lloyd, Tom
AU - Petit, Moira
AU - Macdonald, Heather
AU - Mirwald, Robert L.
AU - Bailey, Don
AU - McKay, Heather
N1 - Funding Information:
The UBC Healthy Bones Study (1999–2006) was supported by the Canadian Institute for Health Research project grant (20RNO793). Additional support was provided by the Michael Smith Foundation for Health Research grant no (20R41770). PBMAS (1991–1998) was supported by the Canadian National Health and Research Development Program (NHRDP), grant no. 6608-1261. PBMAS (2002–2005) was supported by the Canadian Institute of Health Research, grant no. MOP 57671. Additional support was provided by the Saskatchewan Health Research Foundation. Stanford bone study was funded by the NIH, grant DK 45226. The Penn State YWHS was supported by NIH grants from the NICHD-R01 HD25973 (T. Lloyd), M01-RR-10732 (Penn State University GCRC), and NIAMS-K23 AR49040-01A1 (M. Petit). The BUGSY study was supported by an NIH RO1, grant no. AR45655-08.
PY - 2010/1
Y1 - 2010/1
N2 - 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 (LS) 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 males, 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.
AB - 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 (LS) 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 males, 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.
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U2 - 10.1016/j.bone.2009.10.017
DO - 10.1016/j.bone.2009.10.017
M3 - Article
C2 - 19854308
AN - SCOPUS:72049131839
SN - 8756-3282
VL - 46
SP - 208
EP - 216
JO - Bone
JF - Bone
IS - 1
ER -