Bone mineral density by age, gender, pubertal stages, and socioeconomic status in healthy Lebanese children and adolescents

Arabi, Asma; Nabulsi, Mona; Maalouf, Joyce; Choucair, Mahmoud; Khalifé, Hassan; Vieth, Reinhold; Fuleihan, Ghada El‐Hajj

doi:10.1016/j.bone.2004.06.015

Cited by 115 publications

(71 citation statements)

References 58 publications

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“…The results of this study corroborate previous data indicating that vertebral bone density does not differ in male and female subjects before the onset of puberty or after sexual maturity but increases significantly during sexual development and achieves peak values by the end of the 2nd decade of life (31)(32)(33)(34). Our findings are also concordant with those in studies that suggest that sex differences in peak bone mass in the axial skeleton, a major determinant of future susceptibility to vertebral fractures in the elderly, do not result from differences in TBD (31,35).…”

Section: Discussionsupporting

confidence: 90%

“…The data presented in this study are a compilation of multiple investigations on the determinants of bone acquisition in healthy children, adolescents, and young adults at Childrens Hospital Los Angeles, Los Angeles, Calif, from 1992 to 2006 (19,20,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). Included in this study were 1222 white subjects, aged 5-21 years, who were not taking any medications and were not known to have any illness.…”

Section: Methodsmentioning

confidence: 99%

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Quantitative CT Reference Values for Vertebral Trabecular Bone Density in Children and Young Adults

Gilsanz¹,

Pérez²,

Campbell³

et al. 2009

Radiology

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Purpose:To determine normative reference values for vertebral trabecular bone density (TBD) obtained by using quantitative computed tomography (CT) in healthy white children, teenagers, and young adults of both sexes. Materials and Methods:The data presented in this HIPAA-compliant study are a compilation of data from multiple investigations on the determinants of bone acquisition in healthy children conducted at this institution from 1992 to 2006. The institutional review board for clinical investigations approved the protocols for each of these studies, and written informed consent was provided by all parents and/or participants. Quantitative CT measurements of TBD (in milligrams per cubic centimeter) were obtained at the first, second, and third lumbar vertebrae in 1222 healthy white male and female subjects aged 5-21 years (mean age for male subjects, 15.1 years Ϯ 3.6 [standard deviation]; range, 5.6 -21.9 years; mean age for female subjects, 14.2 years Ϯ 3.9; range, 5.7-21.6 years; mean age for both sexes, 14.6 years Ϯ 3.8). Mean and standard deviations for TBD were determined for each age group in 1-year intervals, and Student t tests for unpaired data were performed to compare male subjects with female subjects. Results:TBD increased equally during growth in male and female subjects. Although the percentage increase in TBD was similar for both sexes (23.7% [57 of 241] for male subjects, 22.2% [54 of 243] for female subjects), the rise began and reached peak values at an earlier age in female subjects; increases in TBD occurred from 10 -15 years of age in female subjects, whereas in male subjects, these increases were not observed until age 12 years and were completed at 17 years. Conclusion:This study provides reference standards for quantitative CT bone measurements in children and young adults, which may aid in the diagnosis, prevention, and treatment of pediatric metabolic bone disorders. 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.M easurements of bone density during childhood are commonly obtained to assess the deficiencies in bone accumulation associated with a multitude of pediatric disorders. Moreover, the amount of bone that is gained during growth is an important determinant of the risk for osteoporosis later in life (1,2), and available data suggest that the genetic susceptibility to osteoporosis is detectable in childhood (3). Peak bone mass, a major determinant of the future risk of fractures in the elderly, is largely achieved by the end of sexual development (4).Because of its availability, minimal radiation exposure, and relative ease of use, dual-energy x-ray absorptiometry (DXA) is the most commonly employed quantitative radiologic method to assess bone mass at any age (5). The interpretation of DXA bone studies is considerably more challenging in children than in adults. Although reference data and diagnostic algorithms are avai...

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Quantitative CT Reference Values for Vertebral Trabecular Bone Density in Children and Young Adults

Gilsanz¹,

Pérez²,

Campbell³

et al. 2009

Radiology

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“…Except for the 17 years old boys and girls in the ALSPAC cohort, reporting higher BMD levels at the hip [27] , most studies report lower BMD values for total hip and total body than Fit Futures do [28][29][30][31][32]. After converting Hologic measurements to GE-Lunar [33] mostly all our mean BMD values remained higher, which support our conclusions; the overall tendency of higher Fit Futures than Lunar values, may be explained by true population differences.…”

Section: Discussionsupporting

confidence: 81%

“…Most studies report that late commencement of puberty is associated with lower BMD in both sexes [26,28,39]. For girls with intermediate and late sexual maturation, we found a negative association with BMD levels at the femoral neck as described by Heaney 2000; who reported that late menarche is a skeletal disadvantage, and that there is an association between age at menarche and fracture risk.…”

Section: Discussionsupporting

confidence: 78%

“…For girls with intermediate and late sexual maturation, we found a negative association with BMD levels at the femoral neck as described by Heaney 2000; who reported that late menarche is a skeletal disadvantage, and that there is an association between age at menarche and fracture risk. Boys in the beginning of puberty had considerably lower BMD levels at the total hip compared to those with completed sexual maturation, as indicated by Arabi et al [28].…”

Section: Discussionmentioning

confidence: 75%

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The Tromsø Study: Fit Futures: a study of Norwegian adolescents’ lifestyle and bone health

et al. 2014

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Summary Bone mass achievement predicts later fracture risk. This population-based study describes bone mineral density levels (BMD) and associated factors in Norwegian adolescents. Compared with international reference ranges, BMD levels appear higher and physical activity levels are positively associated with BMD.Purpose Norway has one of the highest reported incidences of osteoporotic fractures. Maximization of peak bone mass may prevent later fractures. This population-based study compared BMD levels of Norwegian adolescents with international reference ranges and explored associated factors.Methods All first year upper secondary school students, aged 15-19 years in the Tromsø region were invited to the Fit Futures study in 2010-2011. Over 90% of the invited participants attended, 508 girls and 530 boys. BMD was measured at total hip, femoral neck and total body by dual x-ray absorptiometry.Lifestyle variables were collected by self-administered questionnaires and interviews. All analyses were performed sex stratified, using linear regression models.Results In girls mean BMD (SD) was 1.060 (0.124), 1.066 (0.123) and 1.142 (0.077) g/cm² at the total hip, femoral neck and total body respectively. In boys corresponding values were 1.116 (0.147), 1.103 (0.150) and 1.182 (0.097), with significant higher values than the Lunar pediatric reference at 16 years of age In girls, height and self-reported intensive physical activity of more than four hours a week and early sexual maturation were positively associated with BMD at both femoral sites (p<0.047). Among boys age, height, body mass index, physical activity and alcohol intake were positively (p<0.038), whereas early stages of sexual maturation and smoking was negatively (p<0.047) related to BMD.Conclusions Despite the heavy fracture burden, Norwegian adolescents´ BMD levels are higher than agematched Caucasians. Physical activity is associated with 1 SD increased BMD levels in those involved in competition or hard training.

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Exposure to Residential Green Space and Bone Mineral Density in Young Children

Sleurs,

Silva,

Bijnens

et al. 2024

JAMA Netw Open

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ImportanceBone mass accrual is influenced by environmental and lifestyle factors. Targeted interventions at the early stages of life might decrease fracture and/or osteoporosis risk later in life.ObjectiveTo investigate whether early-life exposure to residential surrounding green space is associated with a change in bone mineral density in young children.Design, Setting, and ParticipantsIn this prospective birth cohort study (ENVIRONAGE [Environmental Influence on Aging in Early Life]), mother-child pairs from Flanders, Belgium, were recruited at birth and followed up for 4 to 6 years, between October 1, 2014, and July 31, 2021. Data analysis was conducted between January and February 2022.ExposuresGreen space was estimated for high green (&gt;3 m vegetation height), low green (≤3 m vegetation height ), and total green (sum of high and low) within several radii (100-3000 m) around the residence after geocoding of the addresses.Main Outcomes and MeasuresRadial bone mineral density was assessed using quantitative ultrasound measurement at follow-up, measured as the mean of the axially transmitted speed of sound in meters per second. Multiple linear and logistic regression models were used while accounting for relevant covariates and potential confounders.ResultsThe study population comprised 327 children (180 [55.0%] female; mean [SD] age, 4.6 [0.4] years at the follow-up evaluation). Early-life exposure to residential green space was associated with increased childhood bone health. An IQR increment in total green (21.2%) and high green (19.9%) space within 500 m was associated with an increase of 27.38 m/s (95% CI, 9.63-45.13 m/s) and 25.30 m/s (95% CI, 7.93-42.68 m/s) in bone mineral density, respectively. Additionally, an IQR increase in total (25.2%) and high (23.2%) green space within 1000 m was associated with a 67% (odds ratio, 0.33; 95% CI, 0.17-0.61) and 61% (odds ratio, 0.39; 95% CI, 0.18-0.75) lower risk of having a bone density lower than the sex-specific 10th percentile (3567.6 m/s for girls and 3522.8 m/s for boys).Conclusions and RelevanceIn this study of children aged 4 to 6 years, higher bone mineral density and a lower risk of having low bone density were associated with higher residential green space exposure during childhood. These findings highlight the importance of early-life exposure to residential green space on bone health during critical periods of growth and development, with long-term implications.

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Bone mineral density by age, gender, pubertal stages, and socioeconomic status in healthy Lebanese children and adolescents

Cited by 115 publications

References 58 publications

Quantitative CT Reference Values for Vertebral Trabecular Bone Density in Children and Young Adults

Quantitative CT Reference Values for Vertebral Trabecular Bone Density in Children and Young Adults

The Tromsø Study: Fit Futures: a study of Norwegian adolescents’ lifestyle and bone health

Exposure to Residential Green Space and Bone Mineral Density in Young Children

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