PURPOSE: The diversity of pediatric dual-energy x-ray absorptiometry (DXA) bone mineral density (BMD) reference databases raises questions as to whether they are interchangeable in their application. This study examined the comparability of BMD Z-scores generated from the largest available Hologic DXA databases, applied on BMD results of a large series of unselected pediatric patients. METHODS: A total of 2027 BMD scans were extracted from Hologic QDR-4500A machines. Age- and sex-specific BMD Z-scores of children aged 8-17 yr, calculated from six Hologic databases, were compared for lumbar spine (LS) and total body (TB). The final dataset included 708 scans (307 of girls). RESULTS: BMD Z-scores calculated from the six databases were highly correlated but differed significantly (P < 0.001) in both scan regions. Interdatabase Z-score differences (boys/girls, respectively) were up to 0.54/0.55 for LS and 1.0/0.83 for TB. These differences also varied significantly among age groups. In girls, the percentage of LS BMD Z-scores of -2 or below ("low BMD for age") varied between 15.4 and 27.9% (P < 0.012). The percentage of TB BMD Z-scores of -2 or below varied similarly in boys (P < 0.009). CONCLUSIONS: Clinically relevant differences in BMD Z-scores exist between the Hologic databases, revealing a significant potential for misdiagnosis. Ideally, Z-scores should be calculated using model-, brand-, and software-specific reference curves for age, sex, and ethnic group. However, our results can be used to estimate converted values. There are other differences in children's bone mass, shape, strength, and body size that are not detected by DXA.
PURPOSE: The diversity of pediatric dual-energy x-ray absorptiometry (DXA) bone mineral density (BMD) reference databases raises questions as to whether they are interchangeable in their application. This study examined the comparability of BMD Z-scores generated from the largest available Hologic DXA databases, applied on BMD results of a large series of unselected pediatric patients. METHODS: A total of 2027 BMD scans were extracted from Hologic QDR-4500A machines. Age- and sex-specific BMD Z-scores of children aged 8-17 yr, calculated from six Hologic databases, were compared for lumbar spine (LS) and total body (TB). The final dataset included 708 scans (307 of girls). RESULTS: BMD Z-scores calculated from the six databases were highly correlated but differed significantly (P < 0.001) in both scan regions. Interdatabase Z-score differences (boys/girls, respectively) were up to 0.54/0.55 for LS and 1.0/0.83 for TB. These differences also varied significantly among age groups. In girls, the percentage of LS BMD Z-scores of -2 or below ("low BMD for age") varied between 15.4 and 27.9% (P < 0.012). The percentage of TB BMD Z-scores of -2 or below varied similarly in boys (P < 0.009). CONCLUSIONS: Clinically relevant differences in BMD Z-scores exist between the Hologic databases, revealing a significant potential for misdiagnosis. Ideally, Z-scores should be calculated using model-, brand-, and software-specific reference curves for age, sex, and ethnic group. However, our results can be used to estimate converted values. There are other differences in children's bone mass, shape, strength, and body size that are not detected by DXA.
Authors: David R Weber; Alison Boyce; Catherine Gordon; Wolfgang Högler; Heidi H Kecskemethy; Madhusmita Misra; Diana Swolin-Eide; Peter Tebben; Leanne M Ward; Halley Wasserman; Christopher Shuhart; Babette S Zemel Journal: J Clin Densitom Date: 2019-07-10 Impact factor: 2.617
Authors: Joseph M Kindler; Joan M Lappe; Vicente Gilsanz; Sharon Oberfield; John A Shepherd; Andrea Kelly; Karen K Winer; Heidi J Kalkwarf; Babette S Zemel Journal: J Clin Endocrinol Metab Date: 2019-04-01 Impact factor: 5.958
Authors: Babette S Zemel; Halley Wasserman; Andrea Kelly; Bo Fan; John Shepherd; Joan Lappe; Vicente Gilsanz; Sharon Oberfield; Karen K Winer; Heidi J Kalkwarf Journal: Bone Date: 2020-08-11 Impact factor: 4.398
Authors: Jinhui Ma; Kerry Siminoski; Nathalie Alos; Jacqueline Halton; Josephine Ho; Brian Lentle; MaryAnn Matzinger; Nazih Shenouda; Stephanie Atkinson; Ronald Barr; David A Cabral; Robert Couch; Elizabeth A Cummings; Conrad V Fernandez; Ronald M Grant; Celia Rodd; Anne Marie Sbrocchi; Maya Scharke; Frank Rauch; Leanne M Ward Journal: J Clin Endocrinol Metab Date: 2014-12-11 Impact factor: 5.958
Authors: F Lifshitz; J P Hecht; E F Bermúdez; C A Gamba; J M Reinoso; P L Casavalle; S M Friedman; P N Rodriguez Journal: Eur J Clin Nutr Date: 2016-04-27 Impact factor: 4.016
Authors: Leanne M Ward; David R Weber; Craig F Munns; Wolfgang Högler; Babette S Zemel Journal: J Clin Endocrinol Metab Date: 2020-05-01 Impact factor: 5.958