Context: Deficits in bone acquisition during growth may increase fracture risk. Assessment of bone health during childhood requires appropriate reference values relative to age, sex, and population ancestry to identify bone deficits.
Objective: The objective of this study was to provide revised and extended reference curves for bone mineral content (BMC) and areal bone mineral density (aBMD) in children.
Design: The Bone Mineral Density in Childhood Study was a multicenter longitudinal study with annual assessments for up to 7 yr.
Setting: The study was conducted at five clinical centers in the United States.
Participants: Two thousand fourteen healthy children (992 males, 22% African-Americans) aged 5-23 yr participated in the study.
Intervention: There were no interventions.
Main outcome measures: Reference percentiles for BMC and aBMD of the total body, lumbar spine, hip, and forearm were obtained using dual-energy x-ray absorptiometry for Black and non-Black children. Adjustment factors for height status were also calculated.
Results: Extended reference curves for BMC and aBMD of the total body, total body less head, lumbar spine, total hip, femoral neck, and forearm for ages 5-20 yr were constructed relative to sex and age for Black and non-Black children. Curves are similar to those previously published for 7-17 year olds. BMC and aBMD values were greater for Black vs. non-Black children at all measurement sites.
Conclusions: We provide here dual-energy x-ray absorptiometry reference data on a well-characterized cohort of 2012 children and adolescents. These reference curves provide the most robust reference values for the assessment and monitoring of bone health in children and adolescents in the literature to date.
|2020||Robinson M-E, Bardai G, Veilleux L-N, Glorieux FH, Rauch F. Musculoskeletal phenotype in two unrelated individuals with a recurrent nonsense variant in SGMS2. Bone. May 2020;134:115261.|
|2020||Simmons JH, Rush ET, Petryk A, Zhou S, Martos-Moreno GÁ. Dual X-ray absorptiometry has limited utility in detecting bone pathology in children with hypophosphatasia: a pooled post hoc analysis of asfotase alfa clinical trial data. Bone. August 2020;137:115413.|
|2020||Dahan-Oliel N, Collins J, Rauch D, Bukovy G, Hamdy R, Rauch F. Bone densities and bone geometry in children and adolescents with arthrogryposis. Bone. August 2020;137:115454.|
|2020||Nottez A, Kolta S, Lion G, Ternynck C, Legroux-Gérot I, Vantyghem M-C, Cortet B, Paccou J. Prevalence and causes of elevated bone mass. Bone. September 2020;138:115476.|
|2020||Zemel BS, Wasserman H, Kelly A, Fan B, Shepherd J, Lappe J, Gilsanz V, Oberfield S, Winer KK, Kalkwarf HJ. Intermachine differences in DXA measurements vary by skeletal site, and impact the assessment of low bone density in children. Bone. December 2020;141:115581.|
|2020||Kindler JM, Mitchell EL, Piccoli DA, Grimberg A, Leonard MB, Loomes KM, Zemel BS. Bone geometry and microarchitecture deficits in children with Alagille syndrome. Bone. December 2020;141:115576.|
|2021||Lopez-Gonzalez D, Wells JC, Cortina-Borja M, Fewtrell M, Partida-Gaytán A, Clark P. Reference values for bone mineral density in healthy Mexican children and adolescents. Bone. January 2021;142:115734.|
|2021||Lalayiannis AD, Fewtrell M, Biassoni L, Silva S, Goodman N, Shroff R, Crabtree NJ. Studying bone mineral density in young people: the complexity of choosing a pQCT reference database. Bone. February 2021;143:115713.|
|2021||Saha PK, Oweis RR, Zhang X, Letuchy E, Eichenberger-Gilmore JM, Burns TL, Warren JJ, Janz KF, Torner JC, Snetselaar LG, Levy SM. Effects of fluoride intake on cortical and trabecular bone microstructure at early adulthood using multi-row detector computed tomography (MDCT). Bone. May 2021;146:115882.|
|2022||Kuiper JR, Braun JM, Calafat AM, Lanphear BP, Cecil KM, Chen A, Xu Y, Yolton K, Kalkwarf HJ, Buckley JP. Associations of pregnancy phthalate concentrations and their mixture with early adolescent bone mineral content and density: the Health Outcomes and Measures of the Environment (HOME) study. Bone. January 2022;154:116251.|
|2016||Burt LA, Liang Z, Sajobi TT, Hanley DA, Boyd SK. Sex‐ and site‐specific normative data curves for HR‐pQCT. J Bone Miner Res. 2016;31(11):2041-2047.|
|2019||Monjardino T, Henriques A, Moreira C, Rodrigues T, Adubeiro N, Nogueira L, Cooper C, Santos AC, Lucas R. Gestational weight gain and offspring bone mass: different associations in healthy weight versus overweight women. J Bone Miner Res. January 2019;34(1):38-48.|
|2019||Kelly A, Shults J, Mostoufi‐Moab S, McCormack SE, Stallings VA, Schall JI, Kalkwarf HJ, Lappe JM, Gilsanz V, Oberfield SE, Shepherd JA, Winer KK, Leonard MB, Zemel BS. Pediatric bone mineral accrual Z‐score calculation equations and their application in childhood disease. J Bone Miner Res. January 2019;34(1):195-203.|
|2021||Shroff R, Fewtrell M, Heuser A, Kolevica A, Lalayiannis A, McAlister L, Silva S, Goodman N, Schmitt CP, Biassoni L, Rahn A, Fischer D, Eisenhauer A. Naturally occurring stable calcium isotope ratios in body compartments provide a novel biomarker of bone mineral balance in children and young adults. J Bone Miner Res. January 2021;36(1):133-142.|
|2021||Yau MS, Kuipers AL, Price R, Nicolas A, Tajuddin SM, Handelman SK, Arbeeva L, Chesi A, Hsu Y, Liu C, Karasik D, Zemel BS, Grant SF, Jordan JM, Jackson RD, Evans MK, Harris TB, Zmuda JM, Kiel DP. A meta‐analysis of the transferability of bone mineral density genetic loci associations from European to African ancestry populations. J Bone Miner Res. March 2021;36(3):469-479.|
|2020||Zürcher SJ, Borter N, Kränzlin M, Neyer P, Meyer U, Rizzoli R, Kriemler S. Relationship between bone mineral content and bone turnover markers, sex hormones and calciotropic hormones in pre- and early pubertal children. Osteoporos Int. February 2020;31(2):335-349.|
|2020||Nasomyont N, Keefe C, Tian C, Hornung L, Khoury J, Tilden JC, Hochwalt P, Jackson E, Rybalsky I, Wong BL, Rutter MM. Safety and efficacy of teriparatide treatment for severe osteoporosis in patients with Duchenne muscular dystrophy. Osteoporos Int. December 2020;31(12):2449-2459.|
|2021||Tobolsky V. Energy Allocation to Adolescent Skeletal Growth: Impacts of Insulin and Physical Activity [PhD thesis]. Cambridge, MA: Harvard University; April 2021.|