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Interpretation of whole body dual energy X-ray absorptiometry measures in children: comparison with peripheral quantitative computed tomography.
Bone. 2004 Jun; 34(6):1044-52.BONE

Abstract

The assessment of bone health in children requires strategies to minimize the confounding effects of bone size on dual energy X-ray absorptiometry (DXA) areal bone mineral density (BMD) results. Cortical bone composes 80% of the total skeletal bone mass. The objective of this study was to develop analytic strategies for the assessment of whole body DXA that describe the biomechanical characteristics of cortical bone across a wide range of body sizes using peripheral quantitative computed tomography (pQCT) measures of cortical geometry, density (mg/mm(3)), and strength as the gold standard. Whole body DXA (Hologic QDR 4500) and pQCT (Stratec XCT-2000) of the tibia diaphysis were completed in 150 healthy children 6-21 years of age. To assess DXA and pQCT measures relative to age, body size, and bone size, gender-specific regression models were used to establish z scores for DXA bone mineral content (BMC) for age, areal BMD for age, bone area for height, bone area for lean mass, BMC for height, BMC for lean mass, and BMC for bone area; and for pQCT, bone cross-sectional area (CSA) for tibia length and bone strength (stress-strain index, SSI) for tibia length. DXA bone area for height and BMC for height were both strongly and positively associated with pQCT CSA for length and with SSI for length (all P < 0.0001), suggesting that decreases in DXA bone area for height or DXA BMC for height represent narrower bones with less resistance to bending. DXA BMC for age (P < 0.01) and areal BMD (P < 0.05) for age were moderately correlated with strength. Neither DXA bone area for lean mass nor BMC for lean mass correlated with pQCT CSA for length or SSI for length. DXA BMC for bone area was weakly associated with pQCT SSI for length, in females only. Therefore, normalizing whole body DXA bone area for height and BMC for height provided the best measures of bone dimensions and strength. DXA BMC normalized for bone area and lean mass were poor indicators of bone strength.

Authors+Show Affiliations

Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, PA 19104, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15193552

Citation

Leonard, Mary B., et al. "Interpretation of Whole Body Dual Energy X-ray Absorptiometry Measures in Children: Comparison With Peripheral Quantitative Computed Tomography." Bone, vol. 34, no. 6, 2004, pp. 1044-52.
Leonard MB, Shults J, Elliott DM, et al. Interpretation of whole body dual energy X-ray absorptiometry measures in children: comparison with peripheral quantitative computed tomography. Bone. 2004;34(6):1044-52.
Leonard, M. B., Shults, J., Elliott, D. M., Stallings, V. A., & Zemel, B. S. (2004). Interpretation of whole body dual energy X-ray absorptiometry measures in children: comparison with peripheral quantitative computed tomography. Bone, 34(6), 1044-52.
Leonard MB, et al. Interpretation of Whole Body Dual Energy X-ray Absorptiometry Measures in Children: Comparison With Peripheral Quantitative Computed Tomography. Bone. 2004;34(6):1044-52. PubMed PMID: 15193552.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Interpretation of whole body dual energy X-ray absorptiometry measures in children: comparison with peripheral quantitative computed tomography. AU - Leonard,Mary B, AU - Shults,Justine, AU - Elliott,Dawn M, AU - Stallings,Virginia A, AU - Zemel,Babette S, PY - 2003/01/20/received PY - 2003/10/15/revised PY - 2003/12/03/accepted PY - 2004/6/15/pubmed PY - 2005/1/15/medline PY - 2004/6/15/entrez SP - 1044 EP - 52 JF - Bone JO - Bone VL - 34 IS - 6 N2 - The assessment of bone health in children requires strategies to minimize the confounding effects of bone size on dual energy X-ray absorptiometry (DXA) areal bone mineral density (BMD) results. Cortical bone composes 80% of the total skeletal bone mass. The objective of this study was to develop analytic strategies for the assessment of whole body DXA that describe the biomechanical characteristics of cortical bone across a wide range of body sizes using peripheral quantitative computed tomography (pQCT) measures of cortical geometry, density (mg/mm(3)), and strength as the gold standard. Whole body DXA (Hologic QDR 4500) and pQCT (Stratec XCT-2000) of the tibia diaphysis were completed in 150 healthy children 6-21 years of age. To assess DXA and pQCT measures relative to age, body size, and bone size, gender-specific regression models were used to establish z scores for DXA bone mineral content (BMC) for age, areal BMD for age, bone area for height, bone area for lean mass, BMC for height, BMC for lean mass, and BMC for bone area; and for pQCT, bone cross-sectional area (CSA) for tibia length and bone strength (stress-strain index, SSI) for tibia length. DXA bone area for height and BMC for height were both strongly and positively associated with pQCT CSA for length and with SSI for length (all P < 0.0001), suggesting that decreases in DXA bone area for height or DXA BMC for height represent narrower bones with less resistance to bending. DXA BMC for age (P < 0.01) and areal BMD (P < 0.05) for age were moderately correlated with strength. Neither DXA bone area for lean mass nor BMC for lean mass correlated with pQCT CSA for length or SSI for length. DXA BMC for bone area was weakly associated with pQCT SSI for length, in females only. Therefore, normalizing whole body DXA bone area for height and BMC for height provided the best measures of bone dimensions and strength. DXA BMC normalized for bone area and lean mass were poor indicators of bone strength. SN - 8756-3282 UR - https://www.unboundmedicine.com/medline/citation/15193552/Interpretation_of_whole_body_dual_energy_X_ray_absorptiometry_measures_in_children:_comparison_with_peripheral_quantitative_computed_tomography_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S8756328203004587 DB - PRIME DP - Unbound Medicine ER -