Peripheral quantitative computed tomography (pQCT) reveals low bone mineral density in adolescents with motor difficulties

Hands, Beth; Chivers, Paola; McIntyre, Fleur; Bervenotti, F.; Blee, Tanya; Beeson, Brendan; Bettenay, Fiona; Siafarikas, Aris

doi:10.1007/s00198-015-3071-8

Cited by 11 publications

(10 citation statements)

References 39 publications

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“…Motor competence is the ability to carry out motor tasks, and is commonly measured using standardized questionnaires or clinic‐based assessments . Low bone strength has been observed in adolescents with motor difficulties, and children, adolescents, and adults with low motor competence . However, few studies have prospectively collected data on early‐life motor competence and how it influences bone strength in later life.…”

Section: Introductionmentioning

confidence: 99%

Motor Competence in Early Childhood Is Positively Associated With Bone Strength in Late Adolescence

Ireland

Sayers

Deere

et al. 2015

Journal of Bone and Mineral Research

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The onset of walking in early childhood results in exposure of the lower limb to substantial forces from weight bearing activity that ultimately contribute to adult bone strength. Relationships between gross motor score (GMS), at 18 months and bone outcomes measured at age 17 years were examined in 2327 participants in the Avon Longitudinal Study of Parents and Children (ALSPAC). Higher GMS indicated greater motor competence in weight‐bearing activities. Total hip bone mineral density (BMD) and hip cross‐sectional moment of inertia (CSMI) were assessed from dual‐energy X‐ray absorptiometry (DXA). Bone measures including cortical bone mineral content (BMC), periosteal circumference (PC), cortical thickness (CT), cortical bone area (CBA), cortical BMD (BMDC) and cross‐sectional moment of inertia (CSMI) were assessed by peripheral quantitative computed tomography (pQCT) at 50% distal‐proximal length. Before adjustment, GMS was associated with hip BMD, CSMI, and tibia BMC, PC, CT, CBA and CSMI (all p < 0.001) but not BMDC (p > 0.25). Strongest associations (standardized regression coefficients with 95% CI) were between GMS and hip BMD (0.086; 95% CI, 0.067 to 0.105) and tibia BMC (0.105; 95% CI, 0.089 to 0.121). With the exception of hip BMD, larger regression coefficients were observed in males (gender interactions all p < 0.05). Adjustment for lean mass resulted in substantial attenuation of regression coefficients, suggesting associations between impaired motor competence and subsequent bone development are partly mediated by alterations in body composition. In conclusion, impaired motor competence in childhood is associated with lower adolescent bone strength, and may represent a risk factor for subsequent osteoporosis. © 2015 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research (ASBMR).

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Section: Introductionmentioning

confidence: 99%

Motor Competence in Early Childhood Is Positively Associated With Bone Strength in Late Adolescence

Ireland

Sayers

Deere

et al. 2015

Journal of Bone and Mineral Research

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“…Only pQCT allows the assessment of the true BMD (mass divided by volume) or vBMD. Compared to DXA, pQCT has fewer confounding variables, is less biased to bone size, has a faster scan time, very low radiation exposure, and produces three dimensional images (14). Since standard DEXA measurements are affected by bone size, we analyzed our BMD parameters after correcting according to bone size; vBMD was similar among CDGP, FSS, and control groups (p = 0.450).…”

Section: Discussionmentioning

confidence: 97%

“…DEXA is the most preferred method to evaluate bone metabolism in children due to its advantages including non-invasiveness, short scan time, low radiation dose, and good measurement precision. Only pQCT allows the assessment of the true BMD (mass divided by volume) or 'volumetric BMD' (vBMD) (12)(13)(14). Since standard DEXA measurements are affected by bone size, BMD parameters should be analyzed after correction in accordance with bone size.…”

Section: Introductionmentioning

confidence: 99%

Assessment of bone turnover markers and bone mineral density in normal short boys

Aydın

Bideci

Emeksiz

et al. 2015

Journal of Pediatric Endocrinology and Metabolism

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Our data suggest that prepubertal boys with CDPG have normal bone turnover. However, their significantly higher urinary D-pyd levels relative to those of FSS and control groups might be an indicator of later development of osteoporosis. Therefore, long-term follow-up studies monitoring bone mineral status of prepubertal boys with CDPG from prepuberty to adulthood are needed to better understand bone metabolism of these patients.

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“…The AMPitup Program is an exercise intervention program for adolescents with a movement disorder (21), being conducted at the University of Notre Dame Australia, and is reported as the AMPitup dataset in the present paper. The initial bone results of the program have been published previously (12). In brief, participants were aged between 12 and 18 years and were eligible for the AMPitup program if they had a Neuromuscular Development Index (NDI) of 85 or below (≤ 1SD compared to the healthy mean) (mild motor disability) using the McCarron Assessment of Neuromuscular Development (MAND) (22,23), and/or a history of movement difficulties (such as poor coordination or clumsiness, slowness and inaccuracy of motor skills that negatively impact daily living, school, leisure and play activities (24)).…”

Section: Ampitup Datasetmentioning

confidence: 99%

Please Don't Move—Evaluating Motion Artifact From Peripheral Quantitative Computed Tomography Scans Using Textural Features

Rantalainen

Chivers

Beck

et al. 2018

Journal of Clinical Densitometry

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Most imaging methods, including peripheral quantitative computed tomography (pQCT), are susceptible to motion artifacts particularly in fidgety pediatric populations. Methods currently used to address motion artifact include manual screening (visual inspection) and objective assessments of the scans. However, previously reported objective methods either cannot be applied on the reconstructed image or have not been tested for distal bone sites. Therefore, the purpose of the present study was to develop and validate motion artifact classifiers to quantify motion artifact in pQCT scans. Whether textural features could provide adequate motion artifact classification performance in 2 adolescent datasets with pQCT scans from tibial and radial diaphyses and epiphyses was tested. The first dataset was split into training (66% of sample) and validation (33% of sample) datasets. Visual classification was used as the ground truth. Moderate to substantial classification performance (J48 classifier, kappa coefficients from 0.57 to 0.80) was observed in the validation dataset with the novel texture-based classifier. In applying the same classifier to the second cross-sectional dataset, a slight-to-fair (κ = 0.01-0.39) classification performance was observed. Overall, this novel textural analysis-based classifier provided a moderate-to-substantial classification of motion artifact when the classifier was specifically trained for the measurement device and population. Classification based on textural features may be used to prescreen obviously acceptable and unacceptable scans, with a subsequent human-operated visual classification of any remaining scans.

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Peripheral quantitative computed tomography (pQCT) reveals low bone mineral density in adolescents with motor difficulties

Abstract: Motor difficulties in adolescence should be considered a risk factor for below-average bone strength and structure and fracture risk. Strategies are needed to improve bone health in this high-risk-group.

Cited by 11 publications

References 39 publications

Motor Competence in Early Childhood Is Positively Associated With Bone Strength in Late Adolescence

Motor Competence in Early Childhood Is Positively Associated With Bone Strength in Late Adolescence

Assessment of bone turnover markers and bone mineral density in normal short boys

Please Don't Move—Evaluating Motion Artifact From Peripheral Quantitative Computed Tomography Scans Using Textural Features

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