Tishya A L Wren1, Heidi J Kalkwarf2, Babette S Zemel3, Joan M Lappe4, Sharon Oberfield5, John A Shepherd6, Karen K Winer7, Vicente Gilsanz8. 1. Children's Hospital Los Angeles, Los Angeles, CA. Electronic address: twren@chla.usc.edu. 2. Cincinnati Children's Hospital Medical Center, Cincinnati, OH. 3. Children's Hospital of Philadelphia, Philadelphia, PA. 4. Creighton University, Omaha, NE. 5. Columbia University, New York, NY. 6. University of California, San Francisco, San Francisco, CA. 7. National Institute of Child Health and Human Development, Bethesda, MD. 8. Children's Hospital Los Angeles, Los Angeles, CA.
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.
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.
Authors: V Gilsanz; D T Gibbens; T F Roe; M Carlson; M O Senac; M I Boechat; H K Huang; E E Schulz; C R Libanati; C C Cann Journal: Radiology Date: 1988-03 Impact factor: 11.105
Authors: S C Van Coeverden; C M De Ridder; J C Roos; M A Van't Hof; J C Netelenbos; H A Delemarre-Van de Waal Journal: J Bone Miner Res Date: 2001-04 Impact factor: 6.741
Authors: Tishya A L Wren; John A Shepherd; Heidi J Kalkwarf; Babette S Zemel; Joan M Lappe; Sharon Oberfield; Frederick J Dorey; Karen K Winer; Vicente Gilsanz Journal: J Pediatr Date: 2012-09-10 Impact factor: 4.406
Authors: John A Shepherd; Li Wang; Bo Fan; Vicente Gilsanz; Heide J Kalkwarf; Joan Lappe; Ying Lu; Thomas Hangartner; Babette S Zemel; Margaret Fredrick; Sharon Oberfield; Karen K Winer Journal: J Bone Miner Res Date: 2011-11 Impact factor: 6.741
Authors: Rocio Fernández-Ojeda; Rosa M Moruno; M José Miranda; Mercè Giner; M José Montoya; M Angeles Vázquez; Ramón Pérez-Cano Journal: J Clin Densitom Date: 2012-09-12 Impact factor: 2.617
Authors: Giuseppe Saggese; Francesco Vierucci; Flavia Prodam; Fabio Cardinale; Irene Cetin; Elena Chiappini; Gian Luigi De' Angelis; Maddalena Massari; Emanuele Miraglia Del Giudice; Michele Miraglia Del Giudice; Diego Peroni; Luigi Terracciano; Rino Agostiniani; Domenico Careddu; Daniele Giovanni Ghiglioni; Gianni Bona; Giuseppe Di Mauro; Giovanni Corsello Journal: Ital J Pediatr Date: 2018-05-08 Impact factor: 2.638
Authors: Matteo M Pusceddu; Patricia J Stokes; Alice Wong; Melanie G Gareau; Damian C Genetos Journal: J Orthop Res Date: 2019-07-26 Impact factor: 3.494
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: M S Rønne; M Heidemann; A Schou; J O Laursen; A B Bojesen; L Lylloff; S Husby; N Wedderkopp; C Mølgaard Journal: Osteoporos Int Date: 2018-06-12 Impact factor: 4.507
Authors: B Hands; P Chivers; F McIntyre; F C Bervenotti; T Blee; B Beeson; F Bettenay; A Siafarikas Journal: Osteoporos Int Date: 2015-03-10 Impact factor: 4.507