Bone Accrual in Children: Adding Substance to Surfaces

Rauch, Frank

doi:10.1542/peds.2006-2023e

Cited by 51 publications

(52 citation statements)

References 27 publications

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“…In addition, the adolescent years are characterized by an increase in TbTh (43)(44)(45). The approximately 20% lower TbTh value in our subjects with AN compared with healthy control subjects (0.31 vs 0.39 mm, P Ͻ .0001) demonstrates an inability of the AN group to achieve pubertal norms for this parameter.…”

Section: Discussionmentioning

confidence: 63%

Distal Radius in Adolescent Girls with Anorexia Nervosa: Trabecular Structure Analysis with High-Resolution Flat-Panel Volume CT

Bredella

Misra²,

Miller³

et al. 2008

Radiology

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Purpose:To examine trabecular microarchitecture with high-resolution flat-panel volume computed tomography (CT) and bone mineral density (BMD) with dual-energy x-ray absorptiometry (DXA) in adolescent girls with anorexia nervosa (AN) and to compare these results with those in normal-weight control subjects. Materials and Methods:The study was approved by the institutional review board and complied with HIPAA guidelines. Informed consent was obtained. Twenty adolescent girls, 10 with mild AN (mean age, 15.9 years; range, 13-18 years) and 10 ageand sex-matched normal-weight control subjects (mean age, 15.9 years; range, 12-18 years) underwent flat-panel volume CT of distal radius to determine apparent trabecular bone volume fraction (BV/TV), apparent trabecular number (TbN), apparent trabecular thickness (TbTh), and apparent trabecular separation (TbSp). All subjects underwent DXA of spine, hip, and whole body to determine BMD and body composition. The means and standard deviations (SDs) of structure parameters were calculated for AN and control groups. Groups were compared (Student t test). Linear regression analysis was performed. Results:AN subjects compared with control subjects, respectively, showed significantly lower mean values for BV/TV (0.37% Ϯ 0.05 [SD] vs 0.46% Ϯ 0.03, P ϭ .0002) and TbTh (0.31 mm Ϯ 0.03 vs 0.39 mm Ϯ 0.03, P Ͻ .0001) and higher mean values for TbSp (0.54 mm Ϯ 0.13 vs 0.44 mm Ϯ 0.04, P ϭ .02). TbN was lower in AN subjects than in control subjects, but the difference was not significant (1.17 mm Ϫ3 Ϯ 0.15 vs 1.22 mm Ϫ3 Ϯ 0.07, P ϭ .43). There was no significant difference in BMD between AN and control subjects. BMD parameters showed positive correlation with BV/TV and TbTh in the control group (r ϭ 0.55-0.84, P ϭ .05-.01) but not in AN patients. Conclusion:Flat-panel volume CT is effective in evaluation of trabecular structure in adolescent girls with AN and demonstrates that bone structure is abnormal in these patients compared with that in normal-weight control subjects despite normal BMD. RSNA, 2008 Note: This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, use the Radiology Reprints form at the end of this article. Low bone mineral density (BMD) is a serious complication of anorexia nervosa (AN) in adults and adolescents (1,2). Decreased bone mass occurs in multiple skeletal sites and is associated with a sevenfold increased fracture risk that may persist despite recovery (3,4). The onset of AN during the adolescent years is of particular concern because this is a crucial time for bone mass accrual toward achievement of peak bone mass. Deficits in the normal rate of bone mass accrual during this period can result in low peak bone mass and an increased risk of fractures in adult life (2,5). Dual-energy x-ray absorptiometry (DXA) is commonly used for the assessment of BMD; however, it is highly influenced by body size (6), which provides a diagnostic challenge in children with AN, because prolon...

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Section: Discussionmentioning

confidence: 63%

Distal Radius in Adolescent Girls with Anorexia Nervosa: Trabecular Structure Analysis with High-Resolution Flat-Panel Volume CT

Bredella

Misra²,

Miller³

et al. 2008

Radiology

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“…Because the ratio MA/FL increases during puberty for both genders, the development of maximal isometric muscle forces is relatively higher than length growth of the forearm. Rauch et al [20,21,22,23] pointed out that the increase of mechanical challenges and, therefore, the development of muscle forces precedes periosteal bone apposition and the increase of bone mass. This consideration is supported by the present data indicating that length growth of the forearm is faster than the increase of the bone diameter in pubertal females.…”

Section: Discussionmentioning

confidence: 99%

The ‘Functional Muscle-Cartilage Unit’: A Reasonable Approach to Describe a Putative Relationship between Muscle Force and Longitudinal Growth at the Forearm in Children and Adolescents?

Fricke

Beccard²,

Semler³

et al. 2008

Horm Res Paediatr

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Background: Several reports give evidence that the perichondral ossificiation of bone tubes (modeling) strongly depends on muscular forces in children and adolescents. The present analyses intend to investigate the hypothesis that muscular forces also partly determine enchondral ossification and, therefore, longitudinal growth of bone tubes. Subjects and Methods: Analyses were based on a single cross-sectional investigation with peripheral quantitative computed tomography in 296 individuals (age 5–19 years) participating in the Dortmund Nutritional and Anthropometric Longitudinally Designed (DONALD) study. Results: Forearm length (FL) was correlated with body height in gender-related subgroups of prepubertal and pubertal individuals (rs between 0.76 and 0.86). Cross-sectional muscle area (MA) increased faster than FL and faster than cross-sectional bone area (BA) close to the distal growth plate in puberty. Close to the growth plate, longitudinal growth was faster than perichondral ossification in females. The ratio MA/BA (surrogate of pressure on the distal growth plate) was correlated with FL in prepubertal boys (r = –0.249, p = 0.043) and pubertal individuals (r = 0.153, p = 0.051). Conclusions: Results support the hypothesis that longitudinal growth precedes modeling at the distal forearm. Confounding variables such as puberty may modify the relationship between muscle forces and longitudinal growth at the forearm in boys.

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“…Bone growth in width is acquired through bone modeling on the periosteum which increases bone size as well as bone mineral content [90]. During bone formation, osteoblast cells lay down osteoid, made up mainly of collagen type I, which in turn serves as a template to deposit calcium and phosphorus crystals [91][92][93].…”

Section: Modeling and Remodelingmentioning

confidence: 99%

Effect of high-dose vitamin D supplementation on bone density in youth with osteogenesis imperfecta: A randomized controlled trial

Plante

Veilleux

Glorieux

et al. 2016

Bone

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Background Osteogenesis imperfecta (OI) is a genetic disease characterized by fragile bones and short stature. Recently, a positive association was found between serum 25‐hydroxyvitamin D (25OHD) concentrations and lumbar spine areal bone mineral density (LS‐aBMD) z‐scores in this population. Objectives: To assess whether high‐dose vitamin D supplementation (2000 IU) will result in significantly higher LS‐aBMD z‐scores after one‐year; and to evaluate the effect of vitamin D supplementation on lower limb muscle power. Results: At baseline, average serum 25OHD concentration was 65.6 nmol/L (SD 20.4) with no difference seen between treatment groups (p=0.77). Deficient serum 25OHD concentrations (<50 nmol/L) were measured in only 21% of patients at baseline. Supplementation resulted in higher serum 25OHD concentrations in almost all participants (90%) with significantly higher increases seen with 2000 IU (mean [95% C.I.] = 30.5 nmol/L [21.3; 39.6] vs 15.2 nmol/L [6.4; 24.1], p= 0.02). No significant changes were detected in BMD measurements or in lower limb muscle power between treatment groups from baseline to final visit. Conclusions Supplementation with either 400 or 2000 IU of vitamin D translates into significant increases in serum 25OHD concentrations in children with OI. However, increases in baseline serum 25OHD concentrations already within a healthy range (蠅50 nmol/L) do not translate into increases in BMD z‐scores in children with OI. This research was supported by the Shriners Hospital for Children as well as by The Network for Oral and Bone Health Research.

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Bone Accrual in Children: Adding Substance to Surfaces

Cited by 51 publications

References 27 publications

Distal Radius in Adolescent Girls with Anorexia Nervosa: Trabecular Structure Analysis with High-Resolution Flat-Panel Volume CT

Distal Radius in Adolescent Girls with Anorexia Nervosa: Trabecular Structure Analysis with High-Resolution Flat-Panel Volume CT

The ‘Functional Muscle-Cartilage Unit’: A Reasonable Approach to Describe a Putative Relationship between Muscle Force and Longitudinal Growth at the Forearm in Children and Adolescents?

Effect of high-dose vitamin D supplementation on bone density in youth with osteogenesis imperfecta: A randomized controlled trial

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