Bone Mineral Density in Girls with Forearm Fractures

Goulding, Ailsa; Cannan, Ruby; Williams, Sheila; Gold, Elspeth; Taylor, RW; Lewis‐Barned, Nick

doi:10.1359/jbmr.1998.13.1.143

Cited by 381 publications

(276 citation statements)

References 41 publications

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“…(30,31) Larger case-control studies in both girls and boys (3 to 19 years of age) indicated that prevalent distal forearm fractures are associated with significantly lower BMC and aBMD values at the radius but also at the lumbar spine and hip compared with age-matched controls. (6,32) In prospective cohorts of young girls, low areal bone mass was a risk for incident fracture, and the observed low bone mass was found to persist after puberty. (33,34) Moreover, in girls with childhood fractures, a lower BMC, smaller bone area, and smaller bone width as assessed by DXA were observed after puberty (16 years of age) but also prior to menarche (9 years of age).…”

Section: Discussionmentioning

confidence: 99%

Prevalent fractures are related to cortical bone geometry in young healthy men at age of peak bone mass

Taes

Lapauw

Vanbillemont

et al. 2010

Journal of Bone and Mineral Research

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Low areal bone mass is a risk factor for fractures in men. Limited data are available on fractures and bone geometry in men, and the relation with sex steroids is incompletely understood. We investigated prevalent fractures in relation to peak bone mass, bone geometry, and sex steroids in healthy young men. Healthy male siblings (n ¼ 677) at the age of peak bone mass (25 to 45 years) were recruited in a cross-sectional population-based study. Trabecular and cortical bone parameters of the radius and cortical bone parameters of the tibia were assessed using peripheral quantitative computed tomography (pQCT). Areal bone mineral density (aBMD) was determined using dual-energy X-ray absorptiometry (DXA). Sex steroids were determined using immunoassays, and fracture prevalence was assessed using questionnaires. Fractures in young men were associated with a longer limb length, shorter trunk, lower trabecular BMD, smaller cortical bone area, and smaller cortical thickness ( p < .005) but not with bone-size-adjusted volumetic BMD (vBMD). With decreasing cortical thickness [odds ratio (OR) 1.4/SD, p .001] and decreasing cortical area (OR 1.5/SD, p .001), fracture odds ratios increased. No association between sex steroid concentrations and prevalent fractures was observed. Childhood fractures ( 15 years) were associated with a thinner bone cortex (À5%, p .005) and smaller periosteal size (À3%, p .005). Fractures occurring later than 15 years of age were associated with a thinner bone cortex (À3%, p .05) and larger endosteal circumference (þ3%, p .05) without differences in periosteal bone size. In conclusion, prevalent fractures in healthy young men are associated with unfavorable bone geometry and not with cortical vBMD when adjusting for bone size. Moreover, the data suggest different mechanisms of childhood fractures and fractures during adult life. ß 2010 American Society for Bone and Mineral Research. KEY WORDS: pQCT; PEAK BONE MASS; OSTEOPOROSIS; MEN; BONE GEOMETRY; FRACTURE IntroductionB one mass at any stage in adult life is determined by the growth and mineralization of the skeleton during the first two decades of life leading to the peak bone mass (PBM) and by subsequent net changes in bone mass, usually bone loss, starting in the middle of the third decade. (1) Although fracture risk in old age is lower in men than in women, fracture risk is higher in boys and young men than in girls or young women. (2,3) In both young and older subjects, low areal bone mineral density (aBMD) has been associated with increased fracture prevalence, although most evidence has been obtained in women (4,5) or elderly men, (6) and only limited data are available in boys or young men. (7)(8)(9) An important limitation of dual-energy X-ray absorptiometry (DXA) is that it measures projected aBMD and not volumetric BMD (vBMD). In determining PBM and future facture risk, this has important clinical implications because bone strength depends not only on the amount of bone tissue but also on the diameter, shape, and volumetric bone...

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Section: Discussionmentioning

confidence: 99%

Prevalent fractures are related to cortical bone geometry in young healthy men at age of peak bone mass

Taes

Lapauw

Vanbillemont

et al. 2010

Journal of Bone and Mineral Research

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“…Several studies have compared the DXA BMD of normal children and adolescents with forearm fractures to that of age-matched controls without fractures. Most [35][36][37][38][39], but not all [40,41], found that mean DXA BMD was significantly lower in children with forearm fractures than in controls.…”

Section: Skeletal Modeling During Growth and Developmentmentioning

confidence: 91%

A structural approach to the assessment of fracture risk in children and adolescents with chronic kidney disease

Leonard

2007

Pediatr Nephrol

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Children with chronic kidney disease (CKD) have multiple risk factors for impaired accretion of trabecular and cortical bone. CKD during childhood poses an immediate fracture risk and compromises adult bone mass, resulting in significantly greater skeletal fragility throughout life. Highturnover disease initially results in thickened trabeculae, with greater bone volume. As disease progresses, resorption cavities dissect trabeculae, connectivity degrades, and bone volume decreases. Increased bone turnover also results in increased cortical porosity and decreased cortical thickness. Dual-energy X-ray absorptiometry (DXA)-based measures of bone mineral density (BMD) are derived from the total bone mass within the projected bone area (g/cm 2 ), concealing distinct disease effects in trabecular and cortical bone. In contrast, peripheral quantitative computed tomography (pQCT) estimates volumetric BMD (vBMD, g/cm 3 ), distinguishes between cortical and trabecular bone, and provides accurate estimates of cortical dimensions. Recent data have confirmed that pQCT measures of cortical vBMD and thickness provide substantially greater fracture discrimination in adult dialysis patients compared with hip or spine DXA. The following review considers the structural effects of renal osteodystrophy as it relates to fracture risk and the potential advantages and disadvantages of DXA and alternative measures of bone density, geometry, and microarchitecture, such as pQCT, micro-CT (μCT), and micro magnetic resonance imaging (μMRI) for fracture risk assessment.

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“…In spite of this, our fracture cases had lower bone mass and bone area density throughout their skeletons than fracture-free controls, and we suggested that a low bone mineral content relative to body weight might make overweight children vulnerable to fragility fractures. 7,8 Others report low bone density in the spine and radius of overweight children 9 ± 11 and orthopaedic problems such as slipped capital epiphyses of the femora, 12 scoliosis and tibia varu 13 are recognized health risks of childhood obesity.…”

Section: Introductionmentioning

confidence: 99%

Overweight and obese children have low bone mass and area for their weight

et al. 2000

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OBJECTIVES: To determine whether girls and boys categorized from body mass index (BMI) values as overweight or obese for their age have lower bone mineral content (BMC) or lower bone area in relation to total body weight than children of normal adiposity. DESIGN: Cross-sectional study in a university bone research unit. SUBJECTS: Two hundred girls and 136 boys aged 3 ± 19 y recruited from the general population by advertisement. MEASUREMENTS: Total body BMC (g) and bone area (cm 2 ) measured by dual energy X-ray absorptiometry (DXA) in relation to body weight (kg), lean tissue mass (kg) and fat mass (kg) in boys and girls of three different BMI percentile groupings: normal weight (BMI`85th percentile); overweight (85 to 94th BMI percentile); obese ( 95th BMI percentile). RESULTS: Obese children had higher BMC, bone area, and fat mass for chronological age than those of normal body weight (P`0.001). In spite of this the observed values for age-adjusted total body BMC and bone area relative to body weight were each lower than predicted values, in both overweight and obese children (2.5 ± 10.1% less, P`0.05) than in children of lower adiposity. CONCLUSION: In overweight and obese boys and girls there is a mismatch between body weight and bone development during growth: their bone mass and bone area are low for their body weight.

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Bone Mineral Density in Girls with Forearm Fractures

Cited by 381 publications

References 41 publications

Prevalent fractures are related to cortical bone geometry in young healthy men at age of peak bone mass

Prevalent fractures are related to cortical bone geometry in young healthy men at age of peak bone mass

A structural approach to the assessment of fracture risk in children and adolescents with chronic kidney disease

Overweight and obese children have low bone mass and area for their weight

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