骨矿物质密度的种族中立儿科参考范围预测了儿童期潜在的骨折
Babette S Zemel1,2, Karen K Winer3, Andrea Kelly2,4
1Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
The Journal of clinical endocrinology and metabolism
|March 25, 2025
概括
新的种族中立的儿科骨密度参考范围显示,骨折预测得到了改善,特别是在黑人儿童中. 这些范围更代表美国人口,应该考虑临床使用.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 骨健康研究 骨健康研究
- 生物统计学 生物统计学
背景情况:
- 现有的特定种族的儿科骨矿物质密度 (BMD) 参考范围被广泛使用,但其临床实用性仍在争论中.
- 开发区域性BMD和骨矿物质表面密度 (BMAD) 的种族中立儿科参考范围对于公平评估至关重要.
- 以前的算法质疑了基于种族的临床评估在儿科骨健康中的价值.
研究的目的:
- 开发和验证区域性BMD和BMAD的种族中立儿科参考范围.
- 为了比较种族特定与种族中立Z分数对潜在骨折的预测能力.
- 评估种族中立的Z分数与儿童骨折风险的关联.
主要方法:
- 儿童骨矿物质密度研究数据的二次分析.
- 利用来自双能X射线吸收度扫描的纵向BMD和BMAD数据.
- 采用Lambda,Sigma,Mu方法来创建种族中立的参考范围,以及用于骨折预测的Cox比例危险建模.
主要成果:
- 与种族中立的BMD和BMADZ分数相比,黑人儿童的BMD和BMADZ分数较高,与种族特定的Z分数相比,其他群体略低.
- 增长和生活方式因素影响了这些群体差异.
- 在种族中立的Z分数中,一个标准偏差的增加与12-18%的骨折风险降低相关.
结论:
- 这项研究为BMD和BMAD提供了第一个种族中立的儿科参考范围,代表了美国人口.
- 这些种族中立的Z分数显示出与骨折风险的显著关联.
- 建议深思熟虑地实施这些新范围,特别是对以前以种族特定范围评估的黑人儿童.
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