Bone Mineral Density of the Lumbar Spine in White Mediterranean Spanish Children and Adolescents: Changes Related to Age, Sex, and Puberty

Abstract

Bone mineral content was measured by dual-energy x-ray absorptiometry in the lumbar spine at the L2-L4 level with a Lunar DPX densitometer model in 471 healthy white Mediterranean Spanish children and adolescents (256 boys and 215 girls) randomly selected from the urban area of Barcelona. Ages ranged from 3 mo to 21 y. Weight, height, and pubertal development were in the normal age distribution. Bone mineral content values were corrected by the vertebral surface area scanned and expressed as bone mineral density (BMD) values. BMD increased progressively from infancy to adulthood, and values were similar in both sexes, with the only differences related to the earlier onset of puberty in girls. A statistically significant correlation (p < 0.001) was found between BMD values and age, height, and weight. BMD values increased annually, but the periods of higher increase were observed during the first 3 y of life and late puberty. A significant (p < 0.001) increase in BMD was observed between Tanner pubertal stages III and IV and between Tanner stage IV and adult values. Lumbar BMD values peaked in a similar way to growth height velocity during pubertal development. However, the BMD peak seemed to occur somewhat later than height velocity peak, particularly in girls. In conclusion, we report normative data for BMD values at the lumbar level in our normally growing pediatric population and show that the first 3 y of life and adolescence are critical periods for bone mineralization. These data provide a tool for the investigation and follow-up of pediatric populations at risk for low bone mineralization.

Historical Aspects of Osteochondral Junction Studies in Perinatal Autopsies

“…These factors are: genetic, nutritional, sexual, hormonal, local growth factors, and physical activity. [20][21][22][23] These same factors seem to play a role in intrauterine growth and studies published in the past ten years suggest that OCJ abnormalities were more commonly associated with congenital malformations, maternal diseases and/or placental abnormalities. 24,25 The OCJ is formed by cartilage, free bone marrow zone, and newly formed bone.…”

Reduced Bone Mineralization in Adolescent Survivors of Malignant Bone Tumors: Comparison of Quantitative Ultrasound and Dual-Energy X-Ray Absorptiometry

“…Patients with bone tumors had significantly reduced lumbar areal bone mineral density at −0.58 (range −0.92 to −0.24) SDS (P = 0.008) compared with references values (19). Bone mass assessed by QUS was −0.34 (range −0.85 to −0.17) SDS, lower though not significantly (P = 0.18) compared to reference values (28).…”

“…The coefficient of variation was 0.8% for DEXA and 0.7% for QUS. The results were expressed quantitatively as standard deviation scores (SDS) using previously published reference values (19,28).…”

“…Dual-energy x-ray absorptiometry (DEXA) is the most widely used technique for bone mass measurements. Compared with other methods to determine bone mineralization, such as single-and dual-photon absorptiometry and quantitative computed axial tomography, DEXA is especially suitable because of its high reproducibility (99%), low precision errors (1%), and low radiation doses (1-2 mRem) (18,19). Unfortunately, DEXA cannot account for the large changes in body and skeletal size that occur during growth, limiting its use in longitudinal studies in children.…”

“…This is an important quality since the risk of fractures depends not only on bone density but also on the elasticity of bone and its microarchitecture (21). Ultrasound has many other advantages compared with DEXA; there is less influence from both bone and body size, and it has a high reproducibility, with a low coefficient of variation (19). It can be performed in 3 minutes, its costs are low, it is portable, and there is no radiation involved, an aspect especially important in children.…”