International longitudinal pediatric reference standards for bone mineral content

Baxter-Jones, Adam D. G., Burrows, Melonie, Bachrach, Laura K., Lloyd, Tom, Petit, Moira, Macdonald, Heather, Mirwald, Robert L., Bailey, Don and McKay, Heather (2010) International longitudinal pediatric reference standards for bone mineral content. Bone, 46 1: 208-216. doi:10.1016/j.bone.2009.10.017

Author Baxter-Jones, Adam D. G.
Burrows, Melonie
Bachrach, Laura K.
Lloyd, Tom
Petit, Moira
Macdonald, Heather
Mirwald, Robert L.
Bailey, Don
McKay, Heather
Title International longitudinal pediatric reference standards for bone mineral content
Journal name Bone   Check publisher's open access policy
ISSN 8756-3282
Publication date 2010-01
Year available 2009
Sub-type Article (original research)
DOI 10.1016/j.bone.2009.10.017
Volume 46
Issue 1
Start page 208
End page 216
Total pages 9
Editor Roland Baron
Place of publication New York, NY
Publisher Elsevier Inc
Collection year 2010
Language eng
Subject C1
110314 Orthopaedics
920501 Child Health
Abstract To render a diagnosis pediatricians rely upon reference standards for bone mineral density or bone mineral content, which are based on cross-sectional data from a relatively small sample of children. These standards are unable to adequately represent growth in a diverse pediatric population. Thus, the goal of this study was to develop sex and site-specific standards for BMC using longitudinal data collected from four international sites in Canada and the United States. Data from four studies were combined; Saskatchewan Paediatric Bone Mineral Accrual Study (n = 251), UBC Healthy Bones Study (n = 382); Penn State Young Women's Health Study (n = 112) and Stanford's Bone Mineral Accretion study (n = 423). Males and females (8 to 25 years) were measured for whole body (WB), total proximal femur (PF), femoral neck (FN) and lumbar spine (LS) BMC (g). Data were analyzed using random effects models. Bland–Altman was used to investigate agreement between predicted and actual data. Age, height, weight and ethnicity independently predicted BMC accrual across sites (P < 0.05). Compared to White males, Asian males had 31.8 (6.8) g less WB BMC accrual; Hispanic 75.4 (28.2) g less BMC accrual; Blacks 82.8 (26.3) g more BMC accrual with confounders of age, height and weight controlled. We report similar findings for the PF and FN. Models for females for all sites were similar with age, height and weight as independent significant predictors of BMC accrual (P < 0.05). We provide a tool to calculate a child's BMC Z-score, accounting for age, size, sex and ethnicity. In conclusion, when interpreting BMC in pediatrics we recommend standards that are sex, age, size and ethnic specific.
Keyword Children
Adolescent Growth Spurt
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Available online 22 October 2009

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
School of Human Movement and Nutrition Sciences Publications
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Citation counts: TR Web of Science Citation Count  Cited 11 times in Thomson Reuters Web of Science Article | Citations
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Created: Thu, 15 Apr 2010, 11:05:35 EST by Deborah Noon on behalf of Faculty Of Health Sciences