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Pediatric Reference Ranges for Ultradistal Radius Bone Density: Results from the Bone Mineral Density in Childhood

Joseph M Kindler1, Heidi J Kalkwarf2, Joan M Lappe3

  • 1Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

The Journal of Clinical Endocrinology and Metabolism
|June 21, 2020
PubMed

Insights

New reference data for ultradistal (UD) radius bone density in children are now available. These measurements, assessed by dual energy X-ray absorptiometry (DXA), correlate with trabecular bone density and aid in assessing pediatric bone health.

Area of Science:

  • Pediatric Bone Health
  • Skeletal Development
  • Medical Imaging

Background:

  • The ultradistal (UD) radius is a site rich in trabecular bone, measurable by dual energy X-ray absorptiometry (DXA).
  • Existing reference data for UD radius areal bone mineral density (aBMD) are insufficient for clinical interpretation and research in children.

Purpose of the Study:

  • To develop age-, sex-, and population ancestry-specific reference ranges for UD radius aBMD using DXA.
  • To assess the tracking of UD radius aBMD Z-scores over time and their association with other bone density measures.

Main Methods:

  • A multicenter longitudinal study involving 2014 children (ages 5-19) with diverse ancestry.
  • Development of age-, sex-, and ancestry-specific reference curves for UD radius aBMD.
  • Analysis of associations between UD radius aBMD Z-scores and DXA/peripheral quantitative computed tomography (pQCT) bone measures.

Main Results:

  • UD radius aBMD increased nonlinearly with age and was slightly higher in males.
  • UD radius aBMD Z-scores showed strong positive correlations with other skeletal site Z-scores and pQCT measures of total and trabecular volumetric bone mineral density.
  • UD radius aBMD Z-scores demonstrated strong tracking over a 6-year period, irrespective of pubertal status.

Conclusions:

  • UD radius aBMD Z-scores are strongly associated with distal radius trabecular bone density, with minimal confounding by height.
  • The developed reference data provide a valuable resource for evaluating bone health in children.
Abstract

Keywords:
DXAaBMDpediatricreferenceultradistal radius

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