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Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Risk factors associated with low bone mineral density and childhood osteoporosis in a population undergoing skeletal
Berta Magallares1,2,3, Dacia Cerdá4, Jocelyn Betancourt3,5
1Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Insights
Identifying risk factors for low bone mass (LBMca) and childhood osteoporosis (cOP) in growing children is crucial. A study found 10.5% of at-risk children had LBMca and 4.8% had cOP, with sedentary lifestyles being a key factor.
Area of Science:
- Pediatric Endocrinology
- Pediatric Bone Health
- Skeletal Development
Background:
- Early identification of risk factors for low bone mass for chronological age (LBMca) and childhood osteoporosis (cOP) is essential for mitigating long-term skeletal complications in growing children.
- Childhood osteoporosis (cOP) is defined by LBMca (BMD Z-score ≤2) with a history of fractures or presence of vertebral fragility fractures.
Purpose of the Study:
- To identify and analyze risk factors associated with low bone mass and childhood osteoporosis in pediatric patients.
- To determine the prevalence of LBMca and cOP in a cohort of children with identified risk factors.
Main Methods:
- Included patients under 21 with risk factors for LBMca (e.g., malabsorption, chronic diseases, certain medications).
- Collected data on fracture history and physical activity levels.
- Utilized dual-energy x-ray absorptiometry (DXA) for spine and whole-body bone mineral density (BMD) assessment and performed vertebral morphometry. Analyzed associations using age-adjusted linear regression.
Main Results:
- 103 patients (mean age 9.8 years) were studied, with 96.1% having multiple risk factors.
- Prevalence of LBMca was 10.5% and cOP was 4.8%.
- Vertebral BMD correlated positively with male sex. Whole body and total body less head BMD showed negative associations with sedentary lifestyle, fracture history, and current steroid treatment.
Conclusions:
- Pediatric populations at risk frequently present with multiple risk factors, including physical inactivity.
- A significant percentage of children with risk factors exhibit LBMca (10.5%) or cOP (4.8%).
- Longitudinal studies are needed to clarify the long-term impact of factors like age, sex, physical activity, ethnicity, and vitamin D status on pediatric bone health.
Background:
Early identification of risk factors for low bone mass for chronological age (LBMca) and childhood osteoporosis (cOP) in patients undergoing skeletal growth is essential to mitigate long-term skeletal complications. cOP is diagnosed when LBMca (BMD Z-score ≤2) is accompanied by a clinically significant fracture history, or when vertebral fragility fractures are present.
Methods:
Patients under 21 years of age with at least one risk factor for LBMca (malabsorption syndrome, chronic inflammatory diseases, hematological diseases, endocrinopathies, drugs that affect bone metabolism, or insufficient calcium intake) were included. Data on fractures history and physical activity levels were collected. Spine and whole-body dual-energy x-ray absorptiometry (DXA) and vertebral morphometry were performed. Age-adjusted linear regression analysis evaluated associations between bone mineral density (BMD) and risk factors.
Results:
A total of 103 patients were included (mean age 9.8 years; 52.4% female), and 96.1% had more than two risk factors. The prevalence of LBMca was 10.5% and the prevalence of cOP was 4.8%. Vertebral BMD was positively associated with male sex. Whole body BMD was negatively associated with sedentary lifestyle and fracture history. Total body less head BMD showed negative associations with current steroid treatment, sedentary lifestyle, and history of fractures.
Conclusions:
Pediatric populations at risk of LBMca or cOP often have multiple risk factors, notably modifying ones such as physical inactivity. Up to 10.5% of children with risk factors present LBMca and 4.8% have an undiagnosed or unknown cOP. Longitudinal studies are warranted to understand the long-term impact of the identified risk factors, including age, sex, sedentary lifestyle, ethnicity and vitamin D status, on bone health.
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