Vertebral bone density in children: effect of puberty.

Gilsanz, Vicente; Gibbens, D T; Roe, Thomas; Carlson, Michael; Senac, M O; Boechat, M. Ines; Huang, Hsiao‐Ling; Schulz, Eloy; Libanati, Cesar; Cann, Chris

doi:10.1148/radiology.166.3.3340782

Cited by 391 publications

(168 citation statements)

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“…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). Indeed, challenging the view that sex differences in bone mass are caused by differences in bone density are recent observations; these observations were made by using quantitative CT and indicate that, throughout life, female subjects have smaller vertebral bodies, but similar TBD, when compared with male subjects, even after accounting for differences in body size (34).…”

Section: Discussionsupporting

confidence: 91%

“…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: 91%

“…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: 91%

Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

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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“…During puberty, trabecular vBMD increases significantly due to increases in trabecular thickness. The increases in vBMD are comparable in girls and boys [30] but are significantly greater in black adolescents than in white adolescents [31].…”

Section: Skeletal Modeling During Growth and Developmentmentioning

confidence: 83%

A structural approach to the assessment of fracture risk in children and adolescents with chronic kidney disease

Leonard

2007

Pediatr Nephrol

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Children with chronic kidney disease (CKD) have multiple risk factors for impaired accretion of trabecular and cortical bone. CKD during childhood poses an immediate fracture risk and compromises adult bone mass, resulting in significantly greater skeletal fragility throughout life. Highturnover disease initially results in thickened trabeculae, with greater bone volume. As disease progresses, resorption cavities dissect trabeculae, connectivity degrades, and bone volume decreases. Increased bone turnover also results in increased cortical porosity and decreased cortical thickness. Dual-energy X-ray absorptiometry (DXA)-based measures of bone mineral density (BMD) are derived from the total bone mass within the projected bone area (g/cm 2 ), concealing distinct disease effects in trabecular and cortical bone. In contrast, peripheral quantitative computed tomography (pQCT) estimates volumetric BMD (vBMD, g/cm 3 ), distinguishes between cortical and trabecular bone, and provides accurate estimates of cortical dimensions. Recent data have confirmed that pQCT measures of cortical vBMD and thickness provide substantially greater fracture discrimination in adult dialysis patients compared with hip or spine DXA. The following review considers the structural effects of renal osteodystrophy as it relates to fracture risk and the potential advantages and disadvantages of DXA and alternative measures of bone density, geometry, and microarchitecture, such as pQCT, micro-CT (μCT), and micro magnetic resonance imaging (μMRI) for fracture risk assessment.

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“…Cardiovascular fitness and bone mineral density Some studies have found a significant relationship between cardiovascular fitness and bone density [15,55], while others have found no differences between active groups and sedentary groups [7,8,18,30,52]. The relationship of cardiovascular fitness to BMD is probably due to the weight-bearing stimulation that activity itself provides to the skeleton.…”

Section: Physical Activitymentioning

confidence: 99%

Osteoporosis, falls and exercise

Meléndez-Ortega

2007

Eur Rev Aging Phys Act

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Osteoporosis, a manifestation of bone atrophy that leads to great susceptibility to fractures, is a very important public health problem today because of its great morbidity, mortality and important economic repercussions. It is a problem that will tend to become more serious with the increase in the number of elderly persons. Bone mass is gained during adolescence, reaches a plateau during the third decade and remains stable until approximately age 50, after which a progressively gradual loss is observed. There is no real cure for osteoporosis, but a series of strategies can be used to reduce bone loss and improve bone mass. Osteoporosis has been considered a disease that accompanies the process of ageing; however, this fatalistic attitude should be discarded, as it is possible to correct and decrease the risk factors. Intervention strategies are based on three pillars: nutrition, physical activity and pharmacological agents. Physical activities and exercise programmes are important because they not only can counter the loss of bone mass but also improve neuromuscular capacity, maintaining and increasing strength and muscle mass, which can help to avoid falls and reduce their impact and consequences. The general principles that apply to any exercise programme also apply to preventing bone mass loss. They also can be applied to persons with osteoporosis. However, to understand the peculiarities of these programmes, the propensity for suffering fractures of these former groups should be kept in mind. Special care should be taken to avoid falls and injuries. Weight-bearing exercise and resistance training are recommended for the prevention programmes. Other activities such as tai-chi, dancing, gymnastic or callisthenic exercises can help to improve balance, gait and muscle coordination and diminish the risk of falling. These programmes should be complemented with postural education and a series of safety precautions.

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Vertebral bone density in children: effect of puberty.

Cited by 391 publications

References 4 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

A structural approach to the assessment of fracture risk in children and adolescents with chronic kidney disease

Osteoporosis, falls and exercise

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