Bone Mineral Status In Children Research Articles

Radiographic absorptiometry of the phalanges in healthy children and in girls with turner syndrome

Although bone mineral status in children has been measured with various techniques, information about development of the actual bone mass density during childhood and adolescent growth is scarce. Our modified radiographic absorptiometry (RA) determines bone mass density (BMaD) three dimensionally at the diaphyseal and metaphyseal site of the middle phalanx of the left second digit, representing predominantly cortical (50% site) and trabecular bone compartments (25% site), respectively. The objectives of this study were to establish reference curves with 95% prediction intervals of BMaD in relation to bone age (BA) during childhood and adolescence (N = 303) determined by RA. The specific effects of female puberty on BMaD were studied comparing the values of 110 untreated girls with Turner syndrome (TS) with those of the female reference group. For either sex, a piecewise linear model with one inflection point (IP) was postulated for the relationship of both the 25% and 50% site with BA. The IPs appeared at exactly the same BA (11.5 "years") for both the 25% and 50% site in boys and for the 25% site in girls. However, in girls the 50% site IP appeared 0.25 "years" later. All BMaD values to the left of the IPs showed little increase with age. In contrast, the slopes to the right of the IPs showed in both genders regression coefficients of approximately 0.05 for the 25% site. For the 50% site, the regression coefficient in girls was markedly higher (0.075) than in boys (0.058), resulting only in girls in a significant difference between the 25% and the 50% site to the right of the IP (p = 0.03).(ABSTRACT TRUNCATED AT 250 WORDS)

Bone mass in children: Normative values for the 2–20-year-old population

Normative values for bone mass were assessed for whole body bone mineral content (WBBMC), anterior-posterior and lateral lumbar spine, radius, femoral neck, trochanter, and Ward's triangle bone mineral density in 778 healthy children and adolescents (433 females and 345 males) from 2–20 years of age from Argentina. Bone mineral content was assessed by dual energy X-ray absorptiometry (DEXA) (Norland XR-26 HS with dynamic filtration). All subjects were Caucasian. WBBMC maximum mean value for girls was found to be in the 16-year-old group with difference between gender becoming significant in the 17-year-old ( p < 0.05) group. The femoral neck, trochanter, and Ward's triangle BMD values in females increased until 14 years of age, with no significant difference between age groups older than 13. In males, no difference between age groups was seen in groups older than 16 years of age. The radius BMD showed a mild increment through infancy and adolescence in boys and girls. In lumbar spine, the gender differences were significant only in those groups over 16 years old, with boys showing a greater BMD than girls ( p < 0.001). When Tanner stage was considered, the anova analysis showed in males that there were significant differences between stages (1–2, 2–3, and 4–5 ( p < 0.01), but no differences between stages 3–4 for all the sites. In females, there were significant differences between stages 1–2 and 2–3 ( p < 0.01), but not between stages 3–4 and 4–5 for WBBMC, FNBMD and LSBMD. There were no significant differences between Tanner stages for RBMD values. The densitometric values presented are useful to assess bone mineral status in children and adolescents, allowing an improved approach to primary and secondary metabolic bone diseases.

94097158 Effects of nutritional supplementation on bone mineral status of children with rheumatic diseases receiving corticosteroid therapy

94097158 Effects of nutritional supplementation on bone mineral status of children with rheumatic diseases receiving corticosteroid therapy

Bone mineral status in children with phenylketonuria— relationship to nutritional intake and phenylalanine control

The mineral status in phenylketonuria (PKU) was measured by single-photon densitometry of the distal radius and plasma concentrations in 26 subjects. Bone mineral content increased normally with age in the younger children despite strict dietary restrictions. Subjects aged greater than 8 y, however, were frequently below the normal curve for bone mineral content. Blood phenylalanine concentrations were significantly higher in the older group of subjects and this correlated with decreased compliance with dietary prescriptions. PKU children had significantly decreased plasma concentrations of alkaline phosphatase, magnesium, and parathyroid hormone. Subnormal concentrations of plasma zinc and plasma and red blood cell (RBC) copper were common, but RBC zinc was normal. We conclude that compliance with dietary therapy for PKU is associated with normal bone mineral development in young children. Older patients with PKU who follow the diet less carefully are at risk for low bone mineral content.

Bone mineral status in children with turner syndrome. The effects of human growth hormone (hGH)

Bone mineral status in children with turner syndrome. The effects of human growth hormone (hGH)

Dietary Calcium and Bone Mineral Status of Children and Adolescents

We studied 164 healthy, white children aged 2 to 16 years; there were 88 boys and 76 girls. By the method of single photon absorptiometry, we found that age, height, and weight correlated positively with bone mineral content of the radius bone. In the children's diet, most of those aged 2 to 11 years met the recommended dietary allowance (800 mg daily) for calcium. Children older than 11 years had low dietary calcium intake; only 15% met the recommended dietary allowance for calcium (1200 mg daily). Dietary calcium intake was associated with bone mineral status. Children ingesting more than 1000 mg of calcium daily had higher bone mineral content than those ingesting less. Almost all serum determinations of calcium, phosphate, magnesium, alkaline phosphatase, parathyroid hormone, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D were within normal limits and had no correlation with children's bone mineral status.

Long term follow-up of bone mineral status in children with renal disease.

Bone mineral content (BMC) was measured by photon absorptiometry in the non-dominant forearm of children with chronic renal failure followed for a total of 2472 months. From 48 children, 302 measurements were made, and changes which occurred in BMC over time were correlated with several factors. Patients were divided into those who had received glucocorticoids (group 1) and those who had not (group 2). Group 1 patients had a lower mean serum creatinine (Cr) (p less than 0.05), a lower growth velocity (p greater than 0.02) and were more demineralized than group 2 patients. There was no correlation between BMC and height velocity or estimated creatinine clearance. BMC and height Z-score (SDS) were highly correlated. Over the period of study, group 1 patients remained shorter, had a lower height velocity, a lower BMC Z-score and a lower BMC for each serum creatinine level. Long-term therapeutic intervention with oral 1,25(OH)2D improved bone mineral status in three children in the nonsteroid group, but none of those in the steroid group. This study demonstrates that steroid administration is probably the most important factor causing bone demineralization, possibly even more important than renal failure.

Demineralization in Cystic Fibrosis

Bone mineral content, bone width, and their ratio were measured in patients with cystic fibrosis (CF) using monoenergetic photon absorptiometry. Serial measurements of the radius and ulna were made in 27 patients with CF and were compared with 968 age-matched controls. Demineralization was found in 37% of the boys and 63% of the girls. Patients under age 10 years had normal bone mineral content and nine of 15 patients aged 13 or older were demineralized (P less than .01). Demineralization correlated with the extent of weight reduction in patients (P less than .001). Patients most likely to be demineralized were adolescent girls. To our knowledge, this is the first report of bone mineral status of children with CF, and the results indicate that a sizable proportion of these patients may be demineralized without overt rickets.