Bone mass in healthy children: measurement with quantitative DXA.

Southard, Richard; Morris, Joan; Mahan, John D.; Hayes, J. R.; Torch, M A; Sommer, Andreas; Zipf, W B

doi:10.1148/radiology.179.3.2027984

Cited by 299 publications

(122 citation statements)

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“…Mechanical loading during weight-bearing activities stimulates bone formation, and multiple studies in healthy adolescents 8,[71][72][73] and in those with anorexia nervosa [74][75][76][77] have demonstrated that BMD is directly correlated with BMI. Lean body mass is most strongly associated with BMD, 78 but increased adiposity can also be associated with increased fracture risk.…”

Section: Body Weightmentioning

confidence: 99%

Optimizing Bone Health in Children and Adolescents

Daniels¹,

Abrams²,

Corkins³

et al. 2014

Pediatrics

393

310

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The pediatrician plays a major role in helping optimize bone health in children and adolescents. This clinical report reviews normal bone acquisition in infants, children, and adolescents and discusses factors affecting bone health in this age group. Previous recommended daily allowances for calcium and vitamin D are updated, and clinical guidance is provided regarding weight-bearing activities and recommendations for calcium and vitamin D intake and supplementation. Routine calcium supplementation is not recommended for healthy children and adolescents, but increased dietary intake to meet daily requirements is encouraged. The American Academy of Pediatrics endorses the higher recommended dietary allowances for vitamin D advised by the Institute of Medicine and supports testing for vitamin D deficiency in children and adolescents with conditions associated with increased bone fragility. Universal screening for vitamin D deficiency is not routinely recommended in healthy children or in children with dark skin or obesity because there is insufficient evidence of the cost–benefit of such a practice in reducing fracture risk. The preferred test to assess bone health is dual-energy x-ray absorptiometry, but caution is advised when interpreting results in children and adolescents who may not yet have achieved peak bone mass. For analyses, z scores should be used instead of T scores, and corrections should be made for size. Office-based strategies for the pediatrician to optimize bone health are provided. This clinical report has been endorsed by American Bone Health.

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Section: Body Weightmentioning

confidence: 99%

Optimizing Bone Health in Children and Adolescents

Daniels¹,

Abrams²,

Corkins³

et al. 2014

Pediatrics

393

310

View full text Add to dashboard Cite

show abstract

“…The Z-score of the lumbar spine BMD was determined using our institution's normative data based on the report by Southard et al from our institution that studied 218 healthy children, age 1-19 years [18]. The lumbar BMD is adjusted for weight and pubertal status, as multiple regression analyses in this study showed that Tanner stage and weight were the best predictive indicators of bone mass and BMD in children [18]. Total body bone mineral content (BMC) was determined for patients without hardware (e.g.…”

Section: Bone Mineral Density Measurementmentioning

confidence: 99%

Biochemical markers of bone turnover in children with clinical bone fragility

Bowden

Akusoba

Hayes

et al. 2016

Journal of Pediatric Endocrinology and Metabolism

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Background: The role of biochemical bone turnover markers (BTMs) in assessing low bone mass and monitoring bisphosphonate treatment in pediatric patients with clinical bone fragility is not well established. The aim of the study was to examine the correlations of BTMs and the bone mineral density (BMD), and evaluate the effects of bisphosphonates therapy on BTMs in children with clinical bone fragility. Methods: Clinical data of 115 patients with clinical bone fragility (mean age 9.7±5.8 years), 102 of whom received bisphosphonates, were studied. Serum alkaline phosphatase (ALP), osteocalcin (OC), urine pyridinoline (PD) and deoxypyridinoline (DPD), BMD at baseline and subsequent years were analyzed. Results: There was a significant negative correlation between urine PD and lumbar BMD (slope = -0.29, p < 0.001). There were no correlations between BTMs and lumbar BMD Z-score. There was a significant positive correlation between serum OC and serum ALP, urine PD and DPD (p < 0.001). Serum OC, urine PD and DPD index, as expressed as measured value/upper limit of normal value for age, decreased during the first 3 years of bisphosphonate therapy. Conclusions: In children with clinical bone fragility, BTMs correlated with each other, but not with lumbar BMD Z-score. While they were not reliable predictors of degree of low BMD, the bone markers showed suppression during bisphosphonate therapy and may be helpful in monitoring the response to therapy.

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“…Glucocorticoid [26][27][28][29][30][31][32][33][34][35] and methotrexate [36][37][38][39] treatment and cranial irradiation [40][41][42] have been inconsistently associated with the risk of osteopenia. However, findings of these studies have been limited by the generally small and heterogeneously treated patient cohorts.…”

Section: 425mentioning

confidence: 99%

Bone mineral density and osteonecrosis in survivors of childhood allogeneic bone marrow transplantation

Kaste

Shidler

Tong

et al. 2004

Bone Marrow Transplant

109

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Summary:Our purpose was to evaluate frequency and severity of bone mineral decrements and frequency of osteonecrosis in survivors of pediatric allogeneic bone marrow transplantation (alloBMT). We retrospectively reviewed demographic information, treatment, magnetic resonance (MR) imaging studies (hips and knees), and bone mineral density (BMD) studies of 48 patients as measured by quantitative computed tomography (QCT). In all, 24 patients were male; 37 were Caucasian. Median age at alloBMT was 10.3 years (1.6-20.4 years). Of the 48 patients, 43 underwent QCT. Median time between alloBMT and imaging was 5.1 years (1.0-10.2 years). Median BMD Z-score was À0.89 (À4.06 to 3.05). BMD Z-score tended to be associated with female sex (P ¼ 0.0559) but not with age at BMT, race, primary diagnosis, time from alloBMT, T-cell depletion of graft, total-body irradiation, or acute/chronic graft-versus-host disease (GVHD). MR showed osteonecrosis in 19 of 43 (44%). We found no associations between osteonecrosis and sex, race, diagnosis, age at BMT, history of GVHD, time from BMT, or T-cell depletion. Seven patients (15%) had MR changes of osteonecrosis and BMD Z-scores of less than -1 s.d. We conclude that pediatric alloBMT survivors have decreased BMD and are at risk of osteonecrosis. They should be monitored to assure early intervention that may ameliorate adverse outcomes.

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Bone mass in healthy children: measurement with quantitative DXA.

Cited by 299 publications

References 0 publications

Optimizing Bone Health in Children and Adolescents

Optimizing Bone Health in Children and Adolescents

Biochemical markers of bone turnover in children with clinical bone fragility

Bone mineral density and osteonecrosis in survivors of childhood allogeneic bone marrow transplantation

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