A Pediatric Bone Mass Scan Has Poor Ability to Predict Adult Bone Mass: A 28-Year Prospective Study in 214 Children

Abstract

We conducted a prospective study following bone traits from childhood to adulthood.Our aim was to study if a bone mass scan in childhood can be used to predict bone mass in adulthood. We found that a pediatric bone mass scan has poor ability to predict adult bone mass. AbstractPurpose: As the correlation of bone mass from childhood to adulthood is unclear, we conducted a long-term prospective observational study to determine if a pediatric bone mass scan could predict adult bone mass. Methods:We measured cortical bone mineral content (BMC; g), bone mineral density (BMD; g/cm 2 ) and bone width (cm) in the distal forearm by single photon absorptiometry in 120 boys and 94 girls with a mean age of 10 years (range 3-17) and mean 28 years (range 25-29) later. We calculated individual and age specific bone mass Z-scores, using the control cohort included at baseline as reference and evaluated correlations between the two measurements with Pearson's correlation coefficient. Individual Z-scores were also stratified in quartiles to register movements between quartiles from growth to adulthood.Results: BMD Z-scores in childhood and adulthood correlated in both boys (r=0.35; p<0.0001) and girls (r=0.50, p<0.0001) and in both children ≥10 years at baseline (boys r=0.43 and girls r=0.58, both p<0.0001) and in children <10 years at baseline (boys r=0.26 and girls r=0.40, both p<0.05).Of the children in the lowest quartile of BMD, 58% had left the lowest quartile in adulthood. A pediatric bone scan with a value in the lowest quartile had a sensitivity of 48% (95% CI 27%, 69%) and a specificity of 76% (95% CI 66%, 84%) to identify individuals who would remain in the lowest quartile also in adulthood Conclusions: Childhood forearm BMD explained 12% of the variance in adult BMD in men and 25% in women.A pediatric distal forearm BMD scan has poor ability to predict adult bone mass.3

Tracking of Areal Bone Mineral Density From Age Eight to Young Adulthood and Factors Associated With Deviation From Tracking: A 17-Year Prospective Cohort Study

“…One other study had very long‐term follow‐up from childhood to adulthood but it did not measure the important sites of the femoral neck or lumbar spine. This study showed moderate correlation for distal forearm bone mass from childhood (mean age of 10 years; range, 3 to 17 years) to 28 years later . It is nonetheless generally consistent with our findings.…”

Growth and Aging of Proximal Femoral Bone: A Study With Women Spanning Three Generations

“…Another study observed an age‐related decline in areal bone mineral density (aBMD) and section modulus (Z) at the proximal femur from 20 to 80 years . Differences in the BMD of femoral neck in adulthood are largely established before puberty, suggesting that puberty is a critical period for bone growth. However, there are no such longitudinal data from childhood through to old age to confirm whether bone traits established in childhood persist to middle age and old age.…”