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Published on: January 29, 2018
Reference values of bone stiffness index and C-terminal telopeptide in healthy European children
D Herrmann1, T Intemann1, F Lauria2
1Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
Insights
This study establishes age-, sex-, and height-specific reference values for bone stiffness index (SI) and serum carboxy-terminal cross-linking telopeptide of type I collagen (CTX) in children. These findings aid in monitoring bone health and skeletal development in prepubertal youth.
Area of Science:
- Pediatric Endocrinology
- Bone Metabolism Research
- Quantitative Ultrasound
Background:
- Bone health monitoring and skeletal development assessment are crucial for preventing future osteoporosis and fractures.
- Population-based reference values are essential for establishing normative data in children.
- This study introduces the first age-, sex-, and height-specific reference values for bone stiffness index (SI) and serum carboxy-terminal cross-linking telopeptide of type I collagen (CTX) in healthy, prepubertal children.
Purpose of the Study:
- To establish normative, age-, sex-, and height-specific reference values for bone stiffness index (SI) and serum carboxy-terminal cross-linking telopeptide of type I collagen (CTX) in healthy prepubertal children.
- To provide a basis for preventive measures against osteoporosis and osteoporotic fractures later in life.
- To facilitate the evaluation of bone growth and metabolism in epidemiological and clinical contexts.
Main Methods:
- Utilized data from the IDEFICS cohort study (2007-2010) involving 18,745 children from eight European countries.
- Analyzed bone stiffness index (SI) of the calcaneus and serum carboxy-terminal cross-linking telopeptide of type I collagen (CTX) in 10,791 and 1646 children, respectively.
- Employed the General Additive Model for Location Scale and Shape (GAMLSS) to generate percentile curves, accounting for age, sex, height, and distributional characteristics.
Main Results:
- Bone stiffness index (SI) showed a negative association with age and height in children aged 2-5 years, and a positive association in those aged 6-10 years.
- The timing of the SI dip varied with percentile and height; taller children experienced it earlier.
- Serum carboxy-terminal cross-linking telopeptide of type I collagen (CTX) reference curves demonstrated a linear positive association with age and height, with no significant sex differences observed for either SI or CTX.
Conclusions:
- The established reference data provide a foundation for assessing bone growth and metabolism in prepubertal children within research and clinical settings.
- These values can aid in monitoring skeletal development and identifying adverse drug effects during medical treatments.
- This research supports early detection and intervention strategies for bone health in childhood.
Background/Objective:
Quantitative ultrasound measurements and bone metabolic markers can help to monitor bone health and to detect impaired skeletal development. Population-based reference values for children may serve as a basis for preventive measures to reduce the risk of osteoporosis and osteoporotic fractures in later life. This is the first paper providing age-, sex- and height-specific reference values for bone stiffness index (SI) and serum carboxy-terminal cross-linking telopeptide of type I collagen (CTX) in healthy, apparently prepubertal children.
Subjects/Methods:
In the population-based IDEFICS baseline survey (2007-2008) and follow-up (2009-2010), 18,745 children from eight European countries were newly recruited. A total of 10,791 2-10.9-year-old and 1646 3-8.9-year-old healthy children provided data on SI of the right and left calcaneus and serum CTX, respectively. Furthermore, height and weight were measured. Percentile curves were calculated using the General Additive Model for Location Scale and Shape (GAMLSS) to model the distribution of SI and CTX depending on multiple covariates while accounting for dispersion, skewness, and the kurtosis of this distribution.
Results:
SI was negatively associated with age and height in children aged 2-5 years, whereas a positive association was observed in children aged 6-10 years. The dip in SI occurred at older age for higher SI percentiles and was observed earlier in taller children than in smaller children. The CTX reference curves showed a linear-positive association with age and height. No major sex differences were observed for the SI and CTX reference values.
Conclusion:
These reference data lay the ground to evaluate bone growth and metabolism in prepubertal children in epidemiological and clinical settings. They may also inform clinical practice to monitor skeletal development and to assess adverse drug reactions during medical treatments.
