Longitudinal tracking of dual-energy X-ray absorptiometry bone measures over 6 years in children and adolescents

Persistence of low bone mass to maturity

Tishya A L Wren, Heidi J. Kalkwarf, Babette S. Zemel, Joan M. Lappe, Sharon Oberfield, John A. Shepherd, Karen K. Winer, Vicente Gilsanz

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

Objectives Early assessment of bone mass may be useful for predicting future osteoporosis risk if bone measures "track" during growth. This prospective longitudinal multicenter study examined tracking of bone measures in children and adolescents over 6 years to sexual and skeletal maturity. Study design A total of 240 healthy male and 293 healthy female patients, ages 6-17 years, underwent yearly evaluations of height, weight, body mass index, skeletal age, Tanner stage, and dual-energy x-ray absorptiometry (DXA) bone measurements of the whole body, spine, hip, and forearm for 6 years. All subjects were sexually and skeletally mature at final follow-up. Correlation was performed between baseline and 6-year follow-up measures, and change in DXA Z-scores was examined for subjects who had baseline Z <-1.5. Results DXA Z-scores (r = 0.66-0.87) had similar tracking to anthropometric measures (r = 0.64-0.74). Tracking was stronger for bone mineral density compared with bone mineral content and for girls compared with boys. Tracking was weakest during mid- to late puberty but improved when Z-scores were adjusted for height. Almost all subjects with baseline Z <-1.5 had final Z-scores below average, with the majority remaining less than -1.0. Conclusions Bone status during childhood is a strong predictor of bone status in young adulthood, when peak bone mass is achieved. This suggests that bone mass measurements in children and adolescents may be useful for early identification of individuals at risk for osteoporosis later in life.

Original languageEnglish
JournalJournal of Pediatrics
Volume164
Issue number6
DOIs
StatePublished - 2014

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Photon Absorptiometry
Bone and Bones
X-Rays
Bone Density
Osteoporosis
Puberty
Forearm
Multicenter Studies
Longitudinal Studies
Hip
Spine
Body Mass Index
Weights and Measures
Growth

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Longitudinal tracking of dual-energy X-ray absorptiometry bone measures over 6 years in children and adolescents : Persistence of low bone mass to maturity. / Wren, Tishya A L; Kalkwarf, Heidi J.; Zemel, Babette S.; Lappe, Joan M.; Oberfield, Sharon; Shepherd, John A.; Winer, Karen K.; Gilsanz, Vicente.

In: Journal of Pediatrics, Vol. 164, No. 6, 2014.

Research output: Contribution to journalArticle

Wren, Tishya A L ; Kalkwarf, Heidi J. ; Zemel, Babette S. ; Lappe, Joan M. ; Oberfield, Sharon ; Shepherd, John A. ; Winer, Karen K. ; Gilsanz, Vicente. / Longitudinal tracking of dual-energy X-ray absorptiometry bone measures over 6 years in children and adolescents : Persistence of low bone mass to maturity. In: Journal of Pediatrics. 2014 ; Vol. 164, No. 6.
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N2 - Objectives Early assessment of bone mass may be useful for predicting future osteoporosis risk if bone measures "track" during growth. This prospective longitudinal multicenter study examined tracking of bone measures in children and adolescents over 6 years to sexual and skeletal maturity. Study design A total of 240 healthy male and 293 healthy female patients, ages 6-17 years, underwent yearly evaluations of height, weight, body mass index, skeletal age, Tanner stage, and dual-energy x-ray absorptiometry (DXA) bone measurements of the whole body, spine, hip, and forearm for 6 years. All subjects were sexually and skeletally mature at final follow-up. Correlation was performed between baseline and 6-year follow-up measures, and change in DXA Z-scores was examined for subjects who had baseline Z <-1.5. Results DXA Z-scores (r = 0.66-0.87) had similar tracking to anthropometric measures (r = 0.64-0.74). Tracking was stronger for bone mineral density compared with bone mineral content and for girls compared with boys. Tracking was weakest during mid- to late puberty but improved when Z-scores were adjusted for height. Almost all subjects with baseline Z <-1.5 had final Z-scores below average, with the majority remaining less than -1.0. Conclusions Bone status during childhood is a strong predictor of bone status in young adulthood, when peak bone mass is achieved. This suggests that bone mass measurements in children and adolescents may be useful for early identification of individuals at risk for osteoporosis later in life.

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