A Comparison of Calcaneus Ultrasound and Dual X-Ray Absorptiometry in Healthy North American Youths and Young Adults

Lum, Catherine K.; Wang, May‐Choo; Moore, Ellen; Wilson, Darrell M.; Marcus, Robert; Bachrach, Laura K.

doi:10.1016/s1094-6950(06)60406-x

Cited by 44 publications

(14 citation statements)

References 28 publications

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“…Studies in healthy children and in patients with disturbances of growth, disorders of bone and mineral metabolism, or chronic diseases have shown a wide range of correlation between QUS variables measured at the heel (17,18,27,28,57,60,67), proximal phalanges of the hand (29,30,83,84), midshaft tibia or distal third of the radius (58,85) and central, peripheral, or total body BMD assessed by DXA. A mild correlation (r ϭ 0.22) between calcaneal QUS and radial volumetric total BMD by pQCT was found (35).…”

Section: Comparison Among Qus Methods and Between Qus Methods And DXmentioning

confidence: 99%

Quantitative Ultrasound Methods to Assess Bone Mineral Status in Children: Technical Characteristics, Performance, and Clinical Application

Baroncelli¹

2008

Pediatr Res

225

179

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Measurement of bone mineral status may be a useful tool in identifying the children who could be exposed to an increased risk of osteoporosis in adulthood. Dual energy x-ray absorptiometry and peripheral quantitative computed tomography may be used to this purpose, but the exposure to ionizing radiation is a limiting factor for preventive studies in large populations of children. In the last years, quantitative ultrasound (QUS) methods have been developed to assess bone mineral status in some peripheral skeletal sites such as calcaneus, phalanges of the hand, and tibia. QUS techniques are safe, easy to use, radiation-free, and devices are portable, so that they are particularly indicated to assess bone mineral status in children. This review will concentrate on the main methodological principles of ultrasounds and the QUS variables derived from their application to bone tissue, technical differences and performance of QUS methods, factors influencing QUS measurements, normative data and results obtained in children with disturbances of growth or affected by disorders of bone and mineral metabolism, including the assessment of fracture risk, and comparison among QUS, dual energy x-ray absorptiometry, and peripheral quantitative computed tomography methods. (Pediatr Res 63: 220-228, 2008) I n the last years, the demand for measurement of bone mineral status to identify children who could be exposed to an increased risk of osteoporosis in adulthood is rapidly increased. Several disorders, by various mechanisms, may be associated with a reduced bone mineral status; in particular, patients with chronic or genetic diseases, malignancies, acute or chronic disabilities caused by neuromuscular disorders, and patients receiving prolonged glucocorticoid treatment are at risk of fractures by minimal trauma caused by a severe reduction in bone mineral status (1).Moreover, there is a growing demand for assessing the effects of some environmental factors on bone health, such as dietary habits and various degrees of physical activity by using radiationfree techniques. DENSITOMETRIC TECHNIQUES FOR ESTIMATING BONE MINERAL STATUS IN CHILDRENSome densitometric techniques to assess bone mineral status developed for adults have been adapted for the use in children. Dual energy x-ray absorptiometry (DXA) is the most commonly used technique for bone mineral status assessment worldwide. The main advantages of DXA are its wide availability and short scanning times, but the subject is exposed to ionized radiation that varies according to the machinery and the examined skeletal site; anyway, radiation dose to patient from DXA is minimal (0.08 -4.6 Sv and 6.7-31 Sv for pencil beam and fan beam methods, respectively) compared with that given by many other investigations involving ionizing radiation (2). Nevertheless, an important shortcoming of DXA is that it measures bone in two dimensions providing only an estimation of bone density. Indeed, DXA measures an integral areal density that is calculated as bone mineral content/bone su...

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Section: Comparison Among Qus Methods and Between Qus Methods And DXmentioning

confidence: 99%

Quantitative Ultrasound Methods to Assess Bone Mineral Status in Children: Technical Characteristics, Performance, and Clinical Application

Baroncelli¹

2008

Pediatr Res

225

179

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“…Boot, et al using forward regression analysis and independent variables similar to those described here, reported that weight and pubertal stage accounted for 80% of the lumbar spine and 85% of the total body BMD variance in females aged 4-20 years.13 Other investigators have reported similar results.35 Ultrasound has developed increased acceptance in evaluating bone strength and density, as investigators have verified its applicability in assessing bone health in pediatrics. 27,36,37 Although the other models account for a larger variance of the bone mineral measurement using DXA, this model offers an improvement over the previous model to predict calcaneal SI as discussed above. The magnitude of the relationships between SI and the predictor variables is modest, and future models should attempt to improve the prediction of SI.…”

Section: Discussionmentioning

confidence: 96%

Menarchal Status and Calf Circumference Predict Calcaneal Ultrasound Measurements in Girls

Hergenroeder

Hoelscher

Day

et al. 2007

Journal of Adolescent Health

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Purpose-The purpose of this study was to predict calcaneal QUS measurements in healthy adolescent females as a function of anthropometric measures, pubertal stage and menarchal status.Methods-This was a secondary data analysis from a two-year intervention designed to increase bone accretion. Simple Pearson correlation and Spearman's rank correlation analyses, followed by linear stepwise regression analyses were conducted. Setting: 12 middle schools. Participants: 672 female students, baseline; 587 students at 18 months. Main outcome measure: Calcaneal stiffness index (SI) by quantitative ultrasound.Results-Eighty percent of the subjects were premenarchal at baseline; 33% at 18 months. Although SI correlated with self-assessed pubic hair (rho = 0.21) and menarchal status (rho = 0.23, p<0.01 for both) at baseline, the model for predicting SI included menarchal status, not pubic hair, and calf circumference, controlling for BMI (R 2 = 0.22, P< 0.01). At 18 months, SI correlated with self-assessed pubic hair (rho = 0.21) and menarchal status (rho = 0.25, p<0.01 for both). The best model to predict SI included calf circumference and pubic hair stage (R 2 = 0.14, p < 0.01), and not menarchal status as 67% of the subjects at 18 months were postmenarchal.Conclusions-In research assessing calcaneal SI in groups of adolescents, assessment of pubertal stage could be replaced with menarchal status and calf circumference when the majority of subjects are premenarchal. When the majority is postmenarchal, pubic hair stage and calf circumference together may be used to assess for pubertal maturation without menstrual status.

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“…Also other studies comparing calcaneal QUS measurements with DXA measurements in healthy children exist. 6,7,[10][11][12][13] However, most of these studies used the BUA and SOS parameters in addition QUS, DXA and DXL measurements in children I Sioen et al to stiffness indices, which are lacking in this study. Moreover, the part of the body measured by DXA differed between the different studies comparing QUS and DXA.…”

Section: Related To the First Objective Of This Studymentioning

confidence: 99%

“…They even found higher, positive correlations between SI and BMD measurements compared with either BUA or SOS. Lum et al 13 compared QUS measurements with DXA measurements of the lumbar spine, femoral neck and total body in 125 North-American youths aged 9-25 years. BMD at all skeletal sites correlated significantly positively with all QUS parameters.…”

Section: Related To the First Objective Of This Studymentioning

confidence: 99%

“…Currently, only limited comparative data on the estimation of bone mineral status in very young healthy children are available. Other studies comparing calcaneal QUS measurements with DXA measurements in healthy children exist; 6,7,[10][11][12][13] however, these studies were conducted in older children from 6 to 18 years of age. Data on validity in younger children are lacking.…”

Section: Introductionmentioning

confidence: 99%

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The relationship between paediatric calcaneal quantitative ultrasound measurements and dual energy X-ray absorptiometry (DXA) and DXA with laser (DXL) as well as body composition

et al. 2011

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Background: Quantitative ultrasound (QUS) is a quick, non-invasive and inexpensive method to measure bone strength. Moreover, the device is portable, which makes it easy to be used in the field. In contrast to other bone measuring techniques, QUS does not use any ionised radiation. However, the validity of QUS in the measurement of bone health and the relationship between QUS output and body composition have not been assessed in very young children. Objective: To investigate the relationship between paediatric calcaneal QUS and both dual-energy X-ray absorptiometry (DXA) and calcaneal DXA with laser (DXL) and body composition parameters. Subjects: A total of 37 Belgian children (10 boys and 27 girls; 4 to 8 years old) underwent a calcaneal QUS as well as a DXA scan. A total of 24 Swedish children (15 boys and 9 girls; 3 to 5 years old) underwent a calcaneal QUS as well as a heel DXL scan. The height and weight of all children were measured. Results: The QUS stiffness index (SI) was significantly negatively correlated with bone mineral density (BMD) of the total body (r ¼ À0.370, P ¼ 0.02). No significant correlations were found between the SI and DXL results. In the total sample, the SI showed a significant positive correlation with body mass index (BMI) (r ¼ 0.298, P ¼ 0.02), even after correction for age, gender and centre. In the Belgian sample, the SI was also significantly positively correlated with total body fat mass content (r ¼ 0.416, P ¼ 0.01) and body fat percentage (r ¼ 0.566, Po0.01) obtained by whole-body DXA. Conclusion: The SI measured by QUS does not correlate significantly with BMD values measured by DXA or DXL in 3-to 8-year-old children. However, there is a significant positive correlation between SI and BMI and body fat %.

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A Comparison of Calcaneus Ultrasound and Dual X-Ray Absorptiometry in Healthy North American Youths and Young Adults

Cited by 44 publications

References 28 publications

Quantitative Ultrasound Methods to Assess Bone Mineral Status in Children: Technical Characteristics, Performance, and Clinical Application

Quantitative Ultrasound Methods to Assess Bone Mineral Status in Children: Technical Characteristics, Performance, and Clinical Application

Menarchal Status and Calf Circumference Predict Calcaneal Ultrasound Measurements in Girls

The relationship between paediatric calcaneal quantitative ultrasound measurements and dual energy X-ray absorptiometry (DXA) and DXA with laser (DXL) as well as body composition

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