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Normative data for iliac bone histomorphometry in growing children
F H Glorieux1, R Travers, A Taylor
1Department of Surgery, McGill University, Montréal, Québec, Canada. glorieux@shriners.mcgill.ca
Insights
This study provides crucial pediatric bone histomorphometry reference data, revealing age-related increases in bone volume and cortical width. These findings enhance the application of bone histomorphometry in pediatric research.
Area of Science:
- Pediatric Bone Biology
- Skeletal Development
- Histomorphometry
Background:
- Bone histomorphometry offers vital insights into bone development.
- Lack of pediatric reference data has limited its clinical application.
- This study addresses this gap by providing normative pediatric data.
Purpose of the Study:
- To establish reference ranges for pediatric bone histomorphometry.
- To analyze age-dependent changes in bone parameters in children and adolescents.
- To assess the reproducibility of histomorphometric measurements in pediatric bone samples.
Main Methods:
- Collected iliac bone samples from 58 pediatric subjects (1.5-22.9 years).
- Performed histomorphometric analysis on cancellous and cortical bone parameters.
- Utilized tetracycline labeling for dynamic bone formation assessment.
Main Results:
- Significant age-dependent increases in cortical width and cancellous bone volume (due to trabecular thickness).
- Decreased bone formation markers (activation frequency, mineral apposition rate) with age.
- Stable osteoid thickness and bone resorption parameters across age groups.
Conclusions:
- Established essential reference data for pediatric bone histomorphometry.
- Demonstrated significant age-related changes in bone structure and remodeling dynamics.
- Highlighted the reliability of structural and dynamic parameters for pediatric bone analysis.
Abstract:
Many insights into normal and pathologic bone development can only be gained by bone histomorphometry. However, the use of this technique in pediatrics has so far been hampered by the lack of reference data. Therefore, we obtained transfixing iliac bone samples from 58 individuals between 1.5 and 22.9 years of age (25 male; tetracycline labeling performed in 48 subjects), who underwent surgery for reasons independent of abnormalities in bone development and metabolism. The results of histomorphometric analyses of cancellous parameters and cortical width are presented as means and standard deviations, as well as medians and ranges in five age groups. In addition, the original data are available from the authors. There were significant age-dependent increases in both cortical width and cancellous bone volume, the latter being due to an increase in trabecular thickness. Osteoid thickness did not vary significantly with age. Bone surface-based indicators of bone formation showed an age-dependent decline, reflecting similar changes in activation frequency. Mineral apposition rate decreased continuously with age. Parameters of bone resorption did not vary significantly between age groups. Paired biopsies from adjacent sites, obtained in eight subjects, were used to examine the reproducibility of histomorphometric parameters in children. The lowest coefficients of variation (<10%) were found for structural measures, as well as mineral apposition rate and wall thickness. The highest variability was found for cellular parameters. The availability of reference material will greatly facilitate the use of histomorphometry in pediatrics.