大连地区1112名正常人群骨密度测定结果分析

目的：为了了解大连地区正常人群骨密度的水平和特点，以便为本地区骨质疏松症的研究提供有益的参考数据。方法：本研究应用法国DMS公司生产的Challanger双能X线骨密度仪，对大连地区1112名正常人的腰椎和股骨近端骨密度进行了测定。结果：男性各部位骨峰值年龄在20－29岁；女性Ward氏区骨峰值年龄在20－29岁，其他部位骨峰值年龄在30－39岁。女性腰椎前后位、骨股近端峰值骨量大于男性相应部位的峰值骨量，腰椎各部位BMD与股骨近端BMD存在相关性（P＜0．05）。结论：男性各部位骨峰值年龄在20－29岁；女性Ward氏区骨峰值年龄在20－29岁，其他部位骨峰值年龄在30－39岁。女性腰椎前后位、股骨近端峰值骨量大于男性相应部位的峰值骨量，有显差异（P＜0．05）。采椎各部位BMD与股骨近端BMD存在相关性（P＜0．05）。但r值在0．1－0．3之间，两个部位的测量不能相互替代。     

沈阳地区537例正常人双能X线骨密度测量结果

本文随机对沈阳地区２０～８９岁人群中５３７人进行了不同部位的双能ｘ线骨密度（ＢＭＤ）的调查，结果显示：腰椎骨峰值男性见于２０～２９岁，女性见于３０～３９岁，股骨上端（Ｎｅｃｋ，Ｗａｒｄ＇ｓ，Ｔｒｏｃｈ）骨峰值男、女均见于２０～２９岁，同年龄组比较，ＢＭＤ的累积丢失率女性高于男性，且女性５０岁后可见骨量丢失加速，而男性呈缓慢丢失。不论男性、女性，各部位的丢失速度以股骨Ｗａｒｄ＇ｓ段显著。本组的研究结果为本地区、甚至东北地区骨质疏松症的诊断提供了一个可靠的诊断标准，通过骨矿含量及累积丢失率的观察，了解了不同性别、不同年龄骨骼的生长发育及衰老的基本规律，为进行骨质疏松症的群体防治提供了科学依据。     

北京市区1333人双能X线骨密度测定及骨质疏松症患病情况调查

本文随机对北京市区20-94岁人群中1333人进行了不同部位的双能X线骨密度(BMD)的调查，其中女性740人。男性593人，按10岁为一年龄组，将其分为8组，结果显示：腰椎骨峰值女性见于30～39岁，男性见于20～29岁，股骨上端(Neck、Ward’s、Troch)骨峰值男、女均见于20～29岁。BMD累积丢失率女性较男性高，无论男、女股骨上端高于腰椎，股骨上端三个部位中又以Ward’s为著。女性50岁以后可见骨量丢失加速，男性呈缓慢丢失。以同性别、同部位峰值BMD减低两个标准差为诊断骨质疏松症的标准、骨质疏松症患病率49岁以前无论男性或女性均在10％以内，50岁以后随年龄增长而增加，以累积丢失率最高的部位统计，50岁以上女性约为30～40%，男性20%～30％，60岁以上女性约为60～70%，男性25～35%；70岁以上女性达80～90%，男性48～56％；80岁以上女性达85～100%，男性达50～65%。股骨上端各部位骨质疏松症检出率明显高于腰椎。提示：骨质疏松的研究重点在女性，但对男性也不容忽视；股骨上端各部位BMD检测敏感性高于腰椎，对腰椎BMD正常，但有明显骨质增生者应参考股骨上端BMD方能作出正确评价。     

辽宁地区正常成年人不同部位骨密度测量分析

目的 对辽宁地区正常人不同部位骨密度(BMD)测量分析,研究辽宁地区正常人口峰值骨量及骨密度变化,为辽宁地区人口骨密度正常参考数据库及有效予防治疗原发性骨质疏松症提供依据.方法 用法国DMS公司生产Lexxos型双能X线骨密度仪对2489例受试者腰1～腰4正位及髋部(包括股骨颈、大粗隆、粗隆间Ward三角)进行BMD测定.结果 各部位峰值骨量分布,男性25～29岁.女性25～29岁,男性骨峰值量略高于女性,但无统计学差异(P>0.05),20岁以后同年龄组男性骨密度差高于女性.女性从50～64岁组,骨量丢失明显加快;男性无骨量丢失明显加快期.男性在75～89岁组骨密度保持相对稳定,骨量丢失较慢,尤其腰椎骨密度有上升趋势.绘制辽宁地区正常成年人不同性别不同部位骨密度变化曲线.结论 检测结果为辽宁地区骨质疏松症准确诊断提供正常值;该地区正常人成年骨密度变化曲线可为有效予防及治疗原发性骨质疏松症提供准确时机和依据.     

广西南宁地区汉壮族人群骨密度及骨质疏松患病率研究

目的 评估广西南宁地区汉壮族健康人群骨量和骨质疏松(OP)的发病情况。方法 l084名健康人群采用双能x线骨密度仪检测腰椎正位、髋部、前臂的骨密度(BMD)值。按民族、年龄、性别进行分组，以10岁作为1个年龄段。结果 骨峰值年龄分布：男女汉壮族各部位骨峰值年龄在30-39岁，60岁后OP患病率(WHO)汉族男性23．36％，壮族男性25．00％，汉族女性31．69％，壮族女性44．44％，汉壮族男女各年龄段和总体OP患病率差异无显性。结论 广西南宁地区汉壮族男女健康人群峰值骨密度水平及骨质疏松检出率差异无显性。     

北京地区3859名体检人群骨密度调查及骨量异常患病率分析

目的调查北京地区健康体检人群骨密度的情况以及骨量减少和骨质疏松的患病率,为骨质疏松症的防治提供参考。方法选择2017年1月至2018年12月在中日友好医院健康体检中心进行健康体检的人群,排除继发性骨质疏松症及其他影响骨代谢的因素,共3859名。其中男性2067名,女性1792名。年龄20~83岁,平均年龄(51.29±11.18)岁,按性别及年龄每10年一组。采用美国GE公司的LUNAR Prodigy双能X线骨密度仪测量受试者腰椎1~4正位及股骨颈和全髋的骨密度。分析各组不同部位骨密度情况及骨量异常(包括骨量减少和骨质疏松)的患病率。采用SPSS 22.0统计软件进行分析,以P<0.05为差异有统计学意义。结果①男性腰椎1~4骨密度峰值在20~29岁,股骨颈和全髋骨密度峰值在30~39岁。女性各部位骨密度峰值均在30~39岁。②随年龄增长,男性和女性骨量异常患病率均呈上升趋势,50岁以上女性骨量异常患病率显著上升,明显高于同年龄组男性。③30~59岁男性和女性腰椎骨量异常患病率均明显高于髋部;70岁以上男性和60岁以上女性髋部骨量异常患病率明显高于腰椎。结论中老年人群尤其是绝经后女性是骨质疏松症的高危人群;老年人群的骨质疏松筛查可以考虑选择髋部骨密度为主。     

内蒙古地区蒙古族、汉族健康人群股骨近端骨密度及股骨近端相关几何力学参数的研究

目的 通过测量内蒙古地区蒙古族、汉族健康人群股骨近端骨密度及骨结构相关几何力学参数，探讨本地区蒙古族、汉族股骨近端骨密度及骨结构相关几何力学参数随性别、年龄变化的规律。方法 从DXA工作站中选出本次研究需要的1000人次骨密度检查报告，其中蒙古族500例，汉族500例，利用DXA系统中配置的骨科高级专用软件分析股骨近端几何力学参数。结果 蒙古族、汉族男女性别各部位出现骨峰值的年龄段略有不同，二者均表现为年龄愈大，骨密度值愈低(p<0.01)，蒙古族男、女股骨近端CSMI、CSI随年龄增长均逐渐降低(p<0.05)，HAL 、FNW未见与年龄和性别的变化有关(p>0.05)，女性FSI和NSA随年龄增高而下降(p<0.05)，而男性的FSI和NSA未见年龄性变化(p>0.05)。汉族男性股骨近端几何力学参数同当地蒙古族无显著差异，汉族女性股骨近端几何力学参数与当地蒙古族女性有显著性差异(p<0.05)，即随年龄增高NSA略大，HAL略长，FNW略宽。结论 蒙古族、汉族股骨近端骨密度随性别、年龄变化各有其特点，但随年龄增长骨密度值均逐渐降低，股骨近端几何力学参数随性别、年龄变化有差异性。     

乌鲁木齐市汉族、维吾尔族正常人群骨密度DXA测量

目的通过测量乌鲁木齐市1837人次汉族、维吾尔族健康人群的骨密度（Bone Mineral DensityBMD）．确定本地区汉族、维吾尔族DXA测量骨密度的正常参考值范围，建立本地区汉族、维吾尔族DXA测量骨密度的正常数据库，并比较、探讨汉族、维吾尔族BMD随年龄变化的规律。方法使用法国DMS公司生产的Lexxos型双能x线骨密度仪（Duelenergy X-ray absorptiometer，DEXA）对乌鲁木齐地区20，75岁以上的汉族、维吾尔族健康人群的腰椎前后位、左侧股骨近端进行BMD测定。按不同性别每5岁分为一年龄组，得出骨密度均值、标准差，并进行两组样本均数的f检验。结果汉族、维吾尔族男性及女性各部位出现骨峰值的年龄段略有不同，但多数均在40岁前随骨量逐渐增加而达到骨峰值。其后随年龄的增长BMD降低，女性BMD在50岁后加速下降，男性无加速下降的趋势。结论本研究建立了乌鲁木齐市汉族、维吾尔族DXA测量常规检查部位各年龄段BMD的正常值及骨质疏松诊断参考值，为今后骨质疏松的预防、诊断、研究提供了客观数据，也为国内的资料比较提供了依据。     

广州地区1 403例成年女性骨密度测定分析

目的了解本地区成年女性人群腰椎、股骨近端各部位骨密度(Bone mineral density BMD)随年龄、绝经年限、体重、身高的变化规律、各部位骨密度的偏相关分析和多元线性回归分析及骨质疏松患病率情况,为骨质疏松的诊断及预防提供科学依据.方法采用美国NORLAND公司的XR-46系列双能X线骨密度仪测量1 403例成年女性人群腰椎(L2-L4前后位及L3侧位)、非优势(左)股骨近端各部位(股骨颈、大粗隆及Ward's三角)BMD值,按10岁一个年龄组分7组对数据进行统计分析.结果广州地区成年女性腰椎骨峰含量出现在30～39岁组,而股骨近端骨峰含量出现在20～29岁组,腰椎及股骨近端各部位BMD值均随年龄增长而下降,腰椎和Ward's三角部位在50～59岁和60～69岁两年龄组骨量呈快速丢失现象.各部位骨密度的偏相关分析显示各部位的骨密度均呈相关性(P＜0.01).多元线性回归分析显示年龄和体重对绝经前女性股骨颈的骨密度有影响(P＜0.01),而绝经后女性腰3侧位骨密度除了年龄和体重的影响外,身高和绝经年限均对其有影响(P＜0.01).成年女性在达到峰值骨量后随着年龄的增加,各部位骨质疏松的患病率都呈上升趋势.结论女性机体BMD随年龄而变化,年龄、体重、绝经年限及身高等对机体BMD均有一定的影响,保持合适的体重和体型,有利于BMD的增加与维持.对不同年龄段的成年女性人群,预防骨质疏松的发生应以测量不同部位的BMD作为评价手段.     

新疆乌鲁木齐地区维吾尔族健康人群骨矿含量DXA测量分析

目的通过测量乌鲁木齐市1485人维吾尔族健康人群的骨密度(BMD),确定本市BMD正常参考值,并探讨BMD随年龄变化的规律。方法使用法国DMS公司生产的Lexxos型双能X线骨密度仪(Dual-energy X-ray absorptiometer,DXA)对乌鲁木齐市20岁以上的维吾尔族健康人腰椎前后位、左侧股骨近端的BMD进行测定。按不同性别每5岁分为1年龄组,得出BMD值、标准差及累计丢失百分率。结果男性及女性腰椎骨峰值年龄段组均出现在35～39岁组,而股骨近端男性及女性骨峰值年龄段组均出现在20～24岁组,峰值后随年龄增加而骨密度下降,女性在50～74岁呈加速下降趋势,而男性无明显加速下降现象。结论达到骨峰值后BMD随年龄增加而下降,女性绝经后骨量丢失明显加快,男性下降缓慢,女性骨质疏松发病率高于男性。提示预防和治疗骨质疏松的重点在中老年女性,同时老年男性也不容忽视。因此建立本地区健康维吾尔族人群骨峰值及诊断参考值,对于临床诊断早期原发性骨质疏松症有着重要参考意义。     

Regional and total body bone mineral content,bone mineral density,and total body tissue composition in children 8–16 years of age

Summary Normative values for total body bone mineral content (TBBM) and total body bone mineral density (TBMD) were derived from measurements on 234 children 8–16 years of age. In addition, bone mineral content (BMC) and bone mineral density (BMD) values for selected regions of interest and soft tissue (bone free lean and fat) for the total body are presented. Bone mineral and soft tissue values were determined by dual energy X-ray absorptiometry (DXA) using a Hologic QDR-2000 in the array mode. Results of a stepwise multiple regression analysis revealed a significant correlation between bone-free lean tissue (BFLT) and BMD (r² = 0.80) in girls. Adding age to the equation accounted for an additional 2% of the variance (P < 0.05) and height accounted for another 1% of the variance (P < 0.05). Body weight and fat tissue (FT) did not account for any additional variance. In boys BFLT correlated significantly with BMD (r² = 0.75;P < 0.05); none of the other predictor variables accounted for additional variance. No significant differences were found in TBBM or TBMD between boys and girls at any age. There was a significant overall gender effect for only three regions of interest. Boys had greater BMC in the head region and had greater BMD in the upper limbs, but post hoc analysis revealed no significant differences for any specific age groups. Girls had greater overall BMD in the pelvis, but this difference was only significant at the 15–6-year age group. The changes in BFLT and FT over the age ranges were consistent with the growth literature.The normative values can be applied to the assessment of children and adolescents with health problems that may impact on the skeleton as well as to research studies investigating bone mineral development in children.     

Optimal monitoring time interval between DXA measures in children

The monitoring time interval (MTI) is the expected time in years necessary to identify a change between two measures that exceeds the measurement error. Our purpose was to determine MTI values for dual‐energy X‐ray absorptiometry (DXA) scans in normal healthy children, according to age, sex, and skeletal site. 2014 children were enrolled in the Bone Mineral Density in Childhood Study and had DXA scans of the lumbar spine, total hip, nondominant forearm, and whole body. Measurements were obtained annually for seven visits from 2002 to 2010. Annualized rates of change were calculated by age and sex for all bone regions. A subgroup of 155 children ages 6 to 16 years (85 boys) had duplicate scans for calculation of scan precision. The bone mineral density (BMD) regions of interest included the spine, total body less head (TBLH), total hip, femoral neck, and one‐third radius. Bone mineral content (BMC) was also evaluated for the spine and TBLH. The percent coefficient of variation (%CV) and MTI were calculated for each measure as a function of age and sex. The MTI values were substantially less than 1 year for the TBLH and spine BMD and BMC for boys ≤ 17 years and girls ≤ 15 years. The hip and one‐third radius MTIs were generally 1 year in the same group. MTI values as low as 3 months were found during the peak growth years. However, the MTI values in late adolescence for all regions were substantially longer and became nonsensical as each region neared the age for peak bone density. All four DXA measurement sites had reasonable (< 1 year) MTI values for boys ≤ 17 years and girls ≤ 15 years. MTI was neither useful nor stable in late adolescence and young adulthood. Alternative criteria to determine scan intervals must be used in this age range. © 2011 American Society for Bone and Mineral Research     

Reference values for bone mineral density according to age with body size adjustment in Korean children and adolescents

Bone acquisition failure during growth or low bone mineral density (BMD) in childhood and adolescence might increase future osteoporosis risk. To identify these children and adolescents, appropriate reference values are necessary. The robust reference values must be community based as well as sex-, age-, and ethnicity specific. In addition, body size adjustment is necessary because individuals demonstrate different body sizes and different tempos of growth, which affect measured BMD. We aimed to provide reference data with body size adjustment of Korean children and adolescents. We used dual-energy X-ray absorptiometry data of 1,650 subjects (aged 10–20 years; 788 female) from the Korea National Health and Nutrition Examination Survey (2009–2010). The BMD of each region of interest (ROI), including the lumbar spine, total body less head, total body, and femoral neck, were obtained. We calculated the mean and percentiles for each ROI. Because height and weight variations were high and correlated independently with BMD within the same age group, we developed equations to calculate the “predicted BMD Z score.” Although 12.8–17.9 % of subjects with short stature showed a low measured BMD Z score depending on the measured site, only 2.6 % of those of short stature had a low adjusted BMD Z score after applying the predicted BMD Z score. We also compared the BMD of children and adolescents of other ethnicities using the same device. This study provided robust reference values for the assessment and monitoring of bone health in Korean children and adolescents. Additionally, it extended the knowledge of bone acquisition in Asian children and adolescents.     

Femur neck bone mineral density and fracture risk by age,sex, and race or Hispanic origin in older US adults from NHANES III

Summary

We provide the first reference values for bone mineral content and bone mineral density according to age and sex in Iranian children and adolescents. The prevalence of hypovitaminosis D was high, and levels of physical activity were low in our sample. Multiple regression analyses showed age, BMI, and Tanner stage to be the main indicators of bone mineral apparent density.

Purpose

Normal bone structure is formed in childhood and adolescence. The potential determinants which interact with genetic factors to influence bone density include gender, nutritional, lifestyle, and hormonal factors. This study aimed to evaluate bone mineral content (BMC) and the bone mineral density (BMD) and factors that may interfere with it in Iranian children.

Methods

In this cross-sectional study, 476 healthy Iranian children and adolescents (235 girls and 241 boys) aged 9–18 years old participated. BMC and BMD of the lumbar spine, femoral neck, and total body were measured by dual-energy X-ray absorptiometry using a Hologic Discovery device, and bone mineral apparent density (BMAD) of the lumbar spine and the femoral neck were calculated.

Results

We present percentile curves by age derived separately for BMC, BMD, and BMAD of the lumbar spine, left femoral neck, and total body excluding the head for boys and girls. Maximum accretion of BMC and BMD was observed at ages of 11–13 years (girls) and 12–15 years (boys).The prevalence of hypovitaminosis D was high and physical activity was low in our participants. However, in multiple regression analyses, age, BMI, and Tanner stage were the main indicators of BMD and BMAD

Conclusion

These normative data aid in the evaluation of bone density in Iranian children and adolescents. Further research to evaluate the evolution of BMD in Iranian children and adolescents is needed to identify the reasons for significant differences in bone density values between Iranian populations and their Western counterparts.     

Age trends of bone mineral density and percentile curves in healthy Chinese children and adolescents

The clinical utility of dual-energy X-ray absorptiometry (DXA) measurement requires appropriate normative values, designed to be diverse with respect to age, gender and ethnic background. The purpose of this study was to generate age-related trends for bone density in Chinese children and adolescents, and to establish a gender-specific reference database. A total of 1,541 Chinese children and adolescents aged from 5 to 19-years were recruited from southern China. Bone mineral density (BMD), bone mineral content (BMC), and bone area (BA) were measured for the total body (TB) and total body less head (TBLH). The height-for-age, height-for-BA, and BMC-for-BA percentile curves were developed using the least mean square method. TB BMD and TBLH BMD were highly correlated. After 18 years, TB BMD was significantly higher in boys than girls. For TB BMC and TBLH BMC, gender differences were found in age groups 12 years and 16–19 years; however, the TBLH BMD was significantly different between genders >16 years. The head region accounted for 13–52 and 16–49 % of the TB BMC in boys and girls, respectively. Furthermore, the percentages were negatively correlated with age and height. This study describes a gender-specific reference database for Chinese children and adolescents aged 5–19 years. These normative values could be used for clinical assessment in this population.     

Familial interactions and physical,lifestyle, and dietary factors to affect bone mineral density of children in the KNHANES 2009–2010

We examined familial bone mineral density (BMD) interactions between parents and children and lifestyle factors affecting BMD in the Korean general population of children under 20 and parents under 50 years of age. This cross-sectional study included 2,453 participants (667 daughters, 705 sons, 719 mothers, and 362 fathers) in the 2009–2010 Korean National Health and Nutrition Examination Survey. We calculated prevalence ratios and 95 % confidence intervals for BMD values of whole femur, femur neck, lumbar spine, and whole body excluding the head being in the low tertile in adolescents according to parental BMD tertile after adjusting for physical, lifestyle, and dietary factors. For daughters and sons, there were significant differences in BMD at the four bone sites according to age group, body fat percentage, regular walking and exercise, and milk consumption compared to the reference value for each classification category. Surprisingly, there were no differences in BMD according to serum 25-OH-D levels. Birth order affected BMD of only whole body except head, but its impact was less than that of lifestyle factors. The mean differences in BMD between daughters and sons in the first and third parental BMD tertiles were statistically significant. Notably, the prevalence ratio of whole body without head BMD being in the low tertile increased eight and ten-folds in adolescent daughters and sons, respectively, when parents were in the low BMD tertile. In specific bone regions, parental BMD had a greater effect on total femur in daughters but in the lumbar spine in sons. In conclusion, parental BMD positively influences BMD in daughters and sons after adjustment for environmental parameters. This suggests that the children from parents with low BMD need to make an extra effort to increase BMD through dietary and lifestyle changes.     

Low Bone Mineral Density at Initial Diagnosis in Children and Adolescents with Graves’ Disease

Previous studies have reported reduced bone mineral density (BMD) in patients with hyperthyroidism. We assessed the association of BMD in children and adolescents with Graves’ disease (GD) after correcting for potential confounders affecting BMD such as age, sex, and pubertal status. Forty-four children and adolescents with GD and 172 age- and sex-matched healthy controls were enrolled in this study. We analyzed auxological features, BMD, and levels of thyroid hormone, thyroid-stimulating hormone, and thyroid autoantibodies. We measured BMD by dual-energy X-ray absorptiometry at the time of diagnosis in all patients. The mean age of all patients with GD (9 boys and 32 girls) was 12.1 ± 2.2 years (range, 7.0–16.0). Their initial mean free T4 and thyroid-stimulating hormone levels were 3.51 ± 1.56 ng/dL and 0.04 ± 0.03 IU/L, respectively. The mean BMD Z-scores of the lumbar spine (LS), femoral neck, and total body less head of patients with GD were significantly lower than those of control subjects. Eleven patients (26.8%) had low bone density (LS BMD Z-scores < ?2.0). To identify correlations of patient characteristics with BMD Z-scores at each site, alkaline phosphatase had a significant negative correlation with BMD Z-scores at LS and femoral neck, but not total body less head (r = ?0.441; p = 0.004 and r = ?0.351; p = 0.025, respectively). Children and adolescents with newly diagnosed GD had lower bone mass than their healthy peers. These results suggest that BMD measurement at initial evaluation may be necessary in this population.     

Bone mineral density by age, gender, pubertal stages, and socioeconomic status in healthy Lebanese children and adolescents

Gender, ethnicity, and lifestyle factors affect bone mass acquisition during childhood, thus the need for age- and sex-adjusted Z scores using ethnic-specific data for bone mineral density (BMD) measurement. This study aimed at establishing normative data for BMD in healthy Lebanese children and adolescents. Three hundred sixty-three healthy children aged 10 to 17 years (mean+/-SD: 13.1+/-2.0) were studied. BMD, bone mineral content (BMC), and lean mass were measured by dual-energy X-ray absorptiometry (DXA) using a Hologic 4500A device, and apparent volumetric BMD (BMAD) of the lumbar spine and the femoral neck were calculated. BMD, BMC, and BMAD were expressed by age groups and Tanner stages for boys and girls separately. There was a significant effect of age and puberty on all bone parameters, except at the femoral neck BMAD in boys. BMC and BMD were higher at cortical sites in boys, including subtotal body and hip; whereas, in girls, it was higher at a site more enriched in trabecular bone, namely the lumbar spine. At several skeletal sites, girls had significantly higher BMD adjusted for lean mass than boys. By the end of puberty, adolescents had a mean BMD that was 43-66% higher at the lumbar spine and 25-41% higher at cortical sites than pre-pubertal children, depending on the gender. Mean BMD values in the study group were significantly lower (P<0.01) than Western normative values, with Z scores ranging between -0.2 and -1.1. In both genders, children of lower socioeconomic status tended to have lower BMD than those from a higher socioeconomic background. This study allows additional insight into gender dimorphism in mineral accretion during puberty. It also provides a valuable reference database for the assessment of BMD in children with pubertal or growth disorders who are of Middle Eastern origin.     

Ultrasound bone densitometry of the calcaneus,determined with Sahara,in healthy Japanese adolescents: Japanese Population-based Osteoporosis (JPOS) Study

To establish the reference values for quantitative ultrasound (QUS) indices (speed of sound [SOS]), and broadband ultrasonic attenuation [BUA]) in healthy Japanese adolescents, and to evaluate the effects of age and body size on QUS in comparison with their effects on bone mineral density (BMD), 632 healthy adolescents aged 12 through 17 years recruited from a larger cohort study (Japanese Population-based Osteoporosis [JPOS] Study), were examined in terms of bone mass measurements by QUS at the calcaneus (Sahara; Hologic) and by dual-energy X-ray absorptiometry at the distal one-third radius and ultradistal forearm. We present sex- and age-specific mean values of the QUS and BMD indices. BMD increased significantly up to 17 years of age in males and up to 16 years in females. However, the age-related change in the QUS indices in males was not as clear as that seen for BMD and no age-related change in the QUS indices was observed in females. Significant positive correlation coefficients between BMD and body size were observed in both sexes even after adjusting for the effect of age. SOS showed no correlation with body size and BUA showed a positive but weak correlation with body size in both sexes. Thus, the relationships of age and body size to BMD and QUS were different from each other, even though the QUS indices had significant positive correlations with BMD, allowing for the effect of age.Fumiaki Marumo for JPOS Study Group     

Controlled longitudinal study of bone mass accrual in children and adolescents with cystic fibrosis

BACKGROUND: A study was undertaken to observe the gains in bone mass in children and adolescents with cystic fibrosis (CF) over 24 months and to examine the relationship between areal bone mineral density (aBMD) and associated clinical parameters including physical activity, nutrition, and 25-hydroxyvitamin D (25OHD). METHODS: Areal BMD of the total body (TB), lumbar spine (LS), and total femoral neck (FNt) were repeatedly measured in 85 subjects aged 5-18 years with CF and 100 age and sex matched controls over 2 years. At each visit anthropometric variables, nutritional parameters, pubertal status, disease severity, physical activity, dietary calcium, caloric intake, and serum 25OHD were assessed and related to aBMD. RESULTS: After adjusting for age, sex, and height Z-score, gains in LS aBMD in children (5-10 years) and TB and FNt aBMD in adolescents (11-18 years) with CF were significantly less than in controls. Lean tissue mass was significantly associated with TB and LS aBMD gains in children and adolescents and explained a significant proportion of the aBMD deficit observed. Lung function parameters were significantly associated with aBMD gains in adolescents with CF. CONCLUSIONS: Inadequate bone mass accrual during childhood and adolescence contributes to the low bone mass observed in adults with CF. Accounting for the height discrepancy which is frequently observed in those with CF, in addition to age and sex, is important when assessing low bone mass in children and adolescents with CF. To optimise an individual's potential to acquire maximal bone mass, it is necessary to maximise nutritional status and limit the progression of chronic suppurative lung disease.