Desiree Lopez-Gonzalez1, Jonathan C Wells2, Mario Cortina-Borja3, Mary Fewtrell4, Armando Partida-Gaytán5, Patricia Clark6. 1. Clinical Epidemiology Research Unit, Hospital Infantil de México Federico Gómez, Mexico; Universidad Nacional Autonoma de México, Mexico City, Mexico. Electronic address: dradesireelopez@gmail.com. 2. Childhood Nutrition Research Centre, Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, United Kingdom. Electronic address: jonathan.wells@ucl.ac.uk. 3. Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, United Kingdom. Electronic address: m.cortina@ucl.ac.uk. 4. Childhood Nutrition Research Centre, Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, United Kingdom. Electronic address: m.fewtrell@ucl.ac.uk. 5. Universidad Nacional Autonoma de México, Mexico City, Mexico. Electronic address: dr.partida.g@gmail.com. 6. Clinical Epidemiology Research Unit, Hospital Infantil de México Federico Gómez, Mexico; Universidad Nacional Autonoma de México, Mexico City, Mexico. Electronic address: patriciaclark@prodigy.net.mx.
Abstract
INTRODUCTION: Clinical assessment of bone health by Dual-Energy X-ray Absorptiometry (DXA) in the paediatric population requires robust reference values. The International Society for Clinical Densitometry (ISCD) recommends that country/regional reference values ideally should be used to improve precision in bone health assessment. OBJECTIVE: The aim of this study was to provide reference values for relevant bone health variables for healthy Mexican children and adolescents aged 5 to 18 years. METHODS: This was a cross-sectional, stratified and population-based study, that measured a representative sample of healthy Mexican children and adolescents with DXA. We constructed age- and sex-smoothed reference values for areal bone mineral density (aBMD) of total body less head (TBLH), total body (TB), lumbar spine (LS), and bone mineral apparent density (BMAD) for LS, by means of Generalized Additive Models for Location, Scale and Shape (GAMLSS). RESULTS: Reference data including the 3th, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th centiles, along with lambda (L), mu (M) and sigma (S) values, are given for each variable of interest for each sex at 0.25 years intervals. Reference values relative to height and Tanner-stage for both sexes are also provided. Finally, formulas to enable Z score estimation for clinical use are also presented CONCLUSIONS: The sex, age, height, Tanner-stage and ethnic-specific reference data provided in this study should enable more precise assessment of bone health in the Mexican paediatric population. The data presented may also allow for future evaluation of potential similarities and differences across different ethnic groups.
INTRODUCTION: Clinical assessment of bone health by Dual-Energy X-ray Absorptiometry (DXA) in the paediatric population requires robust reference values. The International Society for Clinical Densitometry (ISCD) recommends that country/regional reference values ideally should be used to improve precision in bone health assessment. OBJECTIVE: The aim of this study was to provide reference values for relevant bone health variables for healthy Mexican children and adolescents aged 5 to 18 years. METHODS: This was a cross-sectional, stratified and population-based study, that measured a representative sample of healthy Mexican children and adolescents with DXA. We constructed age- and sex-smoothed reference values for areal bone mineral density (aBMD) of total body less head (TBLH), total body (TB), lumbar spine (LS), and bone mineral apparent density (BMAD) for LS, by means of Generalized Additive Models for Location, Scale and Shape (GAMLSS). RESULTS: Reference data including the 3th, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th centiles, along with lambda (L), mu (M) and sigma (S) values, are given for each variable of interest for each sex at 0.25 years intervals. Reference values relative to height and Tanner-stage for both sexes are also provided. Finally, formulas to enable Z score estimation for clinical use are also presented CONCLUSIONS: The sex, age, height, Tanner-stage and ethnic-specific reference data provided in this study should enable more precise assessment of bone health in the Mexican paediatric population. The data presented may also allow for future evaluation of potential similarities and differences across different ethnic groups.
Keywords:
Adolescents; Bone health; Bone mineral apparent density; Bone mineral density; Children; Dual Energy X-ray Absorptiometry; Mexican; Reference values
Authors: Alma Lidia Almiray-Soto; Edgar Denova-Gutiérrez; Desiree Lopez-Gonzalez; Mara Medeiros; Patricia Clark Journal: Calcif Tissue Int Date: 2022-09-24 Impact factor: 4.000