Peripheral quantitative computed tomography (pQCT) in 12- and 24-month-old children:​ practical aspects and descriptive data

Valkama, Saara<sup>1,2</sup>; Holmlund-Suila, Elisa<sup>1,2</sup>; Ireland, Alex<sup>3</sup>; Hauta-alus, Helena<sup>1,2,4</sup>; Enlund-Cerullo, Maria<sup>1,2,5</sup>; Rosendahl, Jenni<sup>1,2</sup>; Andersson, Sture<sup>1</sup>; Mäkitie, Outi<sup>1,2,5,6</sup>

Affiliations

¹Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

²Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland

³Musculoskeletal Science and Sports Medicine Research Centre, Department of Life Sciences, Manchester Metropolitan University, Manchester, United Kingdom

⁴National Institute for Health and Welfare, Helsinki, Finland

⁵Folkhälsan Research Center, Helsinki, Finland

⁶Department of Molecular Medicine and Surgery, Karolinska Institutet and Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden

Abstract and keywords

Background: Peripheral quantitative computed tomography (pQCT) is a useful tool to assess detailed bone characteristics. Its utility in infants is however limited due to lack of reference data and technical challenges. The purpose of this study was to provide data on length- and weight-adjusted pQCT values and to present a quality grading system for healthy children aged 12 and 24 months.

Material and methods: As a part of the Vitamin D intervention in Infants (VIDI) trial, we collected pQCT and anthropometric data from 855 children at 12 months and from 784 children at 24 months. Bone mineral content (BMC; mg/mm), volumetric bone mineral density (vBMD; mg/cm³), cross-sectional area (CSA; mm²), polar-moment of inertia (PMI; mm4), and periosteal circumference (PsC; mm) were assessed for total bone at 20% distal site of the left tibia using pQCT (Stratec XCT2000L). We evaluated the impact of scan quality on bone measures. Total bone parameters were assessed for boys and girls separately. The means of the bone parameters were also compared in relation to age. The associations between bone parameters and weight, length, sex and scan quality were analyzed.

Results: We included scans with sufficient quality (Grade 1–5) in the final analyses: 679/855 (79%) at 12 months and 709/784 (90%) at 24 months. Altogether 39% of the scans at 12 months and 51% at 24 months were of good or excellent quality (Grade 1–2). Scan quality had an impact on BMCs at 12 and 24 months (p = 0.001 and p = 0.017, respectively) but not on other bone parameters. Boys presented greater total bone BMC, CSA, PMI and PsC values at 12 and 24 months but vBMDs were similar. All bone parameters showed a significant increase between 12 and 24 months for both sexes. When adjusting bone parameters for weight, length and scan quality, differences between sexes disappeared. Weight was the strongest modifier of BMC, CSA, PMI and PsS at 12 and 24 months.

Conclusions: This study increases our understanding on bone parameters in young children and demonstrates the suitability of pQCT in bone research in infants. The described pQCT data and scan quality grading system should prove useful in evaluating data reliability in research settings.

Clinical trial registration number: NCT1723852

Keywords: pQCT; BMC; vBMD; Cross-sectional area; Polar moment of inertia; Periosteal circumference; Children; Infants

Links

DOI: 10.1016/j.bone.2020.115670

PubMed: 33007527

WoS: 000601334100001

History

Received: 2020-05-15

Revised: 2020-09-24

Accepted: 2020-09-24

Online: 2020-09-30

Cited Works (1)

Year	Entry
2016	Weaver CM, Gordon CM, Janz KF, Kalkwarf HJ, Lappe JM, Lewis R, O’Karma M, Wallace TC, Zemel BS. The National Osteoporosis Foundation’s position statement on peak bone mass development and lifestyle factors: a systematic review and implementation recommendations. Osteoporos Int. April 2016;27(4):1281-1386.

Cited By (1)

Year	Entry
2022	Hauta-alus HH, Holmlund-Suila EM, Valkama SM, Enlund-Cerullo M, Rosendahl J, Coghlan RF, Andersson S, Mäkitie O. Collagen X biomarker (CXM), linear growth, and bone development in a vitamin D intervention study in infants. J Bone Miner Res. September 2022;37(9):1653-1664.