Abstract
Context: In children, bone mineral content (BMC) and bone mineral density (BMD) measurements by dual-energy x-ray absorptiometry (DXA) are affected by height status. No consensus exists on how to adjust BMC or BMD (BMC/BMD) measurements for short or tall stature. Objective: The aim of this study was to compare various methods to adjust BMC/BMD for height in healthy children. Design: Data from the Bone Mineral Density in Childhood Study (BMDCS) were used to develop adjustment methods that were validated using an independent cross-sectional sample of healthy children from the Reference Data Project (RDP). Setting: We conducted the study in five clinical centers in the United States. Participants: We included 1546 BMDCS and 650 RDP participants (7 to 17 yr of age, 50% female). Intervention: No interventions were used. Main Outcome Measures:Wemeasured spine and whole body (WB)BMCandBMDZ-scores for age (BMC/BMD age), height age(BMC/BMD height age), height(BMC height), bone mineral apparent density (BMAD age), and height-for-age Z-score (HAZ) (BMC/BMD haz). Results: Spine and WB BMC/BMD ageZ and BMAD ageZ were positively (P <0.005; r = 0.11 to 0.64) associated with HAZ. Spine BMD haz and BMC hazZ were not associated with HAZ; WB BMC hazZ was modestly associated with HAZ (r = 0.14; P = 0.0003). All other adjustment methods were negatively associated with HAZ (P <0.005; r = -0.20 to -0.34). The deviation between adjusted and BMC/BMD age Z-scores was associated with age for most measures (P <0.005) except for BMC/BMD haz. Conclusions: Most methods to adjustBMC/BMDZ-scores for height were biased by age and/or HAZ. Adjustments using HAZ were least biased relative to HAZ and age and can be used to evaluate the effect of short or tall stature on BMC/BMD Z-scores.
| Original language | English |
|---|---|
| Pages (from-to) | 1265-1273 |
| Number of pages | 9 |
| Journal | Journal of Clinical Endocrinology and Metabolism |
| Volume | 95 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 2010 |
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All Science Journal Classification (ASJC) codes
- Biochemistry
- Clinical Biochemistry
- Endocrinology
- Biochemistry, medical
- Endocrinology, Diabetes and Metabolism
Cite this
Height adjustment in assessing dual energy x-ray absorptiometry measurements of bone mass and density in children. / Zemel, Babette S.; Leonard, Mary B.; Kelly, Andrea; Lappe, Joan M.; Gilsanz, Vicente; Oberfield, Sharon; Mahboubi, Soroosh; Shepherd, John A.; Hangartner, Thomas N.; Frederick, Margaret M.; Winer, Karen K.; Kalkwarf, Heidi J.
In: Journal of Clinical Endocrinology and Metabolism, Vol. 95, No. 3, 03.2010, p. 1265-1273.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Height adjustment in assessing dual energy x-ray absorptiometry measurements of bone mass and density in children
AU - Zemel, Babette S.
AU - Leonard, Mary B.
AU - Kelly, Andrea
AU - Lappe, Joan M.
AU - Gilsanz, Vicente
AU - Oberfield, Sharon
AU - Mahboubi, Soroosh
AU - Shepherd, John A.
AU - Hangartner, Thomas N.
AU - Frederick, Margaret M.
AU - Winer, Karen K.
AU - Kalkwarf, Heidi J.
PY - 2010/3
Y1 - 2010/3
N2 - Context: In children, bone mineral content (BMC) and bone mineral density (BMD) measurements by dual-energy x-ray absorptiometry (DXA) are affected by height status. No consensus exists on how to adjust BMC or BMD (BMC/BMD) measurements for short or tall stature. Objective: The aim of this study was to compare various methods to adjust BMC/BMD for height in healthy children. Design: Data from the Bone Mineral Density in Childhood Study (BMDCS) were used to develop adjustment methods that were validated using an independent cross-sectional sample of healthy children from the Reference Data Project (RDP). Setting: We conducted the study in five clinical centers in the United States. Participants: We included 1546 BMDCS and 650 RDP participants (7 to 17 yr of age, 50% female). Intervention: No interventions were used. Main Outcome Measures:Wemeasured spine and whole body (WB)BMCandBMDZ-scores for age (BMC/BMD age), height age(BMC/BMD height age), height(BMC height), bone mineral apparent density (BMAD age), and height-for-age Z-score (HAZ) (BMC/BMD haz). Results: Spine and WB BMC/BMD ageZ and BMAD ageZ were positively (P <0.005; r = 0.11 to 0.64) associated with HAZ. Spine BMD haz and BMC hazZ were not associated with HAZ; WB BMC hazZ was modestly associated with HAZ (r = 0.14; P = 0.0003). All other adjustment methods were negatively associated with HAZ (P <0.005; r = -0.20 to -0.34). The deviation between adjusted and BMC/BMD age Z-scores was associated with age for most measures (P <0.005) except for BMC/BMD haz. Conclusions: Most methods to adjustBMC/BMDZ-scores for height were biased by age and/or HAZ. Adjustments using HAZ were least biased relative to HAZ and age and can be used to evaluate the effect of short or tall stature on BMC/BMD Z-scores.
AB - Context: In children, bone mineral content (BMC) and bone mineral density (BMD) measurements by dual-energy x-ray absorptiometry (DXA) are affected by height status. No consensus exists on how to adjust BMC or BMD (BMC/BMD) measurements for short or tall stature. Objective: The aim of this study was to compare various methods to adjust BMC/BMD for height in healthy children. Design: Data from the Bone Mineral Density in Childhood Study (BMDCS) were used to develop adjustment methods that were validated using an independent cross-sectional sample of healthy children from the Reference Data Project (RDP). Setting: We conducted the study in five clinical centers in the United States. Participants: We included 1546 BMDCS and 650 RDP participants (7 to 17 yr of age, 50% female). Intervention: No interventions were used. Main Outcome Measures:Wemeasured spine and whole body (WB)BMCandBMDZ-scores for age (BMC/BMD age), height age(BMC/BMD height age), height(BMC height), bone mineral apparent density (BMAD age), and height-for-age Z-score (HAZ) (BMC/BMD haz). Results: Spine and WB BMC/BMD ageZ and BMAD ageZ were positively (P <0.005; r = 0.11 to 0.64) associated with HAZ. Spine BMD haz and BMC hazZ were not associated with HAZ; WB BMC hazZ was modestly associated with HAZ (r = 0.14; P = 0.0003). All other adjustment methods were negatively associated with HAZ (P <0.005; r = -0.20 to -0.34). The deviation between adjusted and BMC/BMD age Z-scores was associated with age for most measures (P <0.005) except for BMC/BMD haz. Conclusions: Most methods to adjustBMC/BMDZ-scores for height were biased by age and/or HAZ. Adjustments using HAZ were least biased relative to HAZ and age and can be used to evaluate the effect of short or tall stature on BMC/BMD Z-scores.
UR - http://www.scopus.com/inward/record.url?scp=77749246331&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77749246331&partnerID=8YFLogxK
U2 - 10.1210/jc.2009-2057
DO - 10.1210/jc.2009-2057
M3 - Article
C2 - 20103654
AN - SCOPUS:77749246331
VL - 95
SP - 1265
EP - 1273
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 3
ER -