Changes in Vertebral Bone Density in Black Girls and White Girls during Childhood and Puberty

Gilsanz, Vicente; Roe, Thomas; Mora, Stefano; Costin, Gertrude; Goodman, William G.

doi:10.1056/nejm199112053252302

Cited by 358 publications

(126 citation statements)

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“…The results of this study corroborate previous data indicating that vertebral bone density does not differ in male and female subjects before the onset of puberty or after sexual maturity but increases significantly during sexual development and achieves peak values by the end of the 2nd decade of life (31)(32)(33)(34). Our findings are also concordant with those in studies that suggest that sex differences in peak bone mass in the axial skeleton, a major determinant of future susceptibility to vertebral fractures in the elderly, do not result from differences in TBD (31,35).…”

Section: Discussionsupporting

confidence: 91%

“…The data presented in this study are a compilation of multiple investigations on the determinants of bone acquisition in healthy children, adolescents, and young adults at Childrens Hospital Los Angeles, Los Angeles, Calif, from 1992 to 2006 (19,20,(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35). Included in this study were 1222 white subjects, aged 5-21 years, who were not taking any medications and were not known to have any illness.…”

Section: Methodsmentioning

confidence: 99%

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Quantitative CT Reference Values for Vertebral Trabecular Bone Density in Children and Young Adults

Gilsanz¹,

Pérez²,

Campbell³

et al. 2009

Radiology

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Purpose:To determine normative reference values for vertebral trabecular bone density (TBD) obtained by using quantitative computed tomography (CT) in healthy white children, teenagers, and young adults of both sexes. Materials and Methods:The data presented in this HIPAA-compliant study are a compilation of data from multiple investigations on the determinants of bone acquisition in healthy children conducted at this institution from 1992 to 2006. The institutional review board for clinical investigations approved the protocols for each of these studies, and written informed consent was provided by all parents and/or participants. Quantitative CT measurements of TBD (in milligrams per cubic centimeter) were obtained at the first, second, and third lumbar vertebrae in 1222 healthy white male and female subjects aged 5-21 years (mean age for male subjects, 15.1 years Ϯ 3.6 [standard deviation]; range, 5.6 -21.9 years; mean age for female subjects, 14.2 years Ϯ 3.9; range, 5.7-21.6 years; mean age for both sexes, 14.6 years Ϯ 3.8). Mean and standard deviations for TBD were determined for each age group in 1-year intervals, and Student t tests for unpaired data were performed to compare male subjects with female subjects. Results:TBD increased equally during growth in male and female subjects. Although the percentage increase in TBD was similar for both sexes (23.7% [57 of 241] for male subjects, 22.2% [54 of 243] for female subjects), the rise began and reached peak values at an earlier age in female subjects; increases in TBD occurred from 10 -15 years of age in female subjects, whereas in male subjects, these increases were not observed until age 12 years and were completed at 17 years. Conclusion:This study provides reference standards for quantitative CT bone measurements in children and young adults, which may aid in the diagnosis, prevention, and treatment of pediatric metabolic bone disorders. Note: This copy is for your personal, non-commercial use only. To order presentation-ready copies for distribution to your colleagues or clients, use the Radiology Reprints form at the end of this article.M easurements of bone density during childhood are commonly obtained to assess the deficiencies in bone accumulation associated with a multitude of pediatric disorders. Moreover, the amount of bone that is gained during growth is an important determinant of the risk for osteoporosis later in life (1,2), and available data suggest that the genetic susceptibility to osteoporosis is detectable in childhood (3). Peak bone mass, a major determinant of the future risk of fractures in the elderly, is largely achieved by the end of sexual development (4).Because of its availability, minimal radiation exposure, and relative ease of use, dual-energy x-ray absorptiometry (DXA) is the most commonly employed quantitative radiologic method to assess bone mass at any age (5). The interpretation of DXA bone studies is considerably more challenging in children than in adults. Although reference data and diagnostic algorithms are avai...

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Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Quantitative CT Reference Values for Vertebral Trabecular Bone Density in Children and Young Adults

Gilsanz¹,

Pérez²,

Campbell³

et al. 2009

Radiology

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“…Trabecular vBMD, as measured by spine QCT, does not increase before puberty [28,29]. During puberty, trabecular vBMD increases significantly due to increases in trabecular thickness.…”

Section: Skeletal Modeling During Growth and Developmentmentioning

confidence: 86%

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 contrast, the whole BMD of spine in human males are greater than in females after puberty [8,15,25]. Gilsanz et al reported that the BMD of vertebral bone during the final stages of puberty in African-American girls was substantially higher than in Caucasian American girls, although BMD did not differ between the two groups before the onset of puberty and during the early stages of puberty [14]. They The explanatory note was described on (a).…”

Section: Discussionmentioning

confidence: 99%

Age-Related Changes of Bone Mineral Density and Microarchitecture in Miniature Pigs

Inui

Itamoto

Takuma³

et al. 2004

J. Vet. Med. Sci.

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ABSTRACT. Bone mineral density (BMD), distribution of its density and bone histomorphometric parameters were evaluated in lumbar vertebra of normally growing miniature pigs. The fourth lumbar vertebra (L4) of the Göttingen miniature pig were used in this cross-sectional study in vitro. The BMD of the miniature pig was similar to that of humans in tendency of gender differences and some growth patterns during puberty. In these regards this animal appears useful as a model for human bone study. However, the trabecular and cortical BMDs of lumbar spine were extremely high value (399.43 ± 26.36 mg/cm 3 in female trabeculae; 973.06 ± 69.55 mg/cm 3 in female cortical bone; 419.04 ± 34.84 mg/cm 3 in male trabeculae; 1038.81 ± 125.72 mg/cm 3 in male cortical bone in pigs 30 months or more). Furthermore, histomorphometric analysis yielded values that were remarkably different from those found in humans. From these results, it was revealed that miniature pig had a higher bone mass and denser trabecular network than human, indicating that its bone is probably stronger. Therefore, care should be taken in choosing the miniature pig as a bone study model. KEY WORDS: bone mineral density, histomorphometric analyses, lumbar spine, miniature pig.J. Vet. Med. Sci. 66(6): 599-609, 2004 Metabolic bone diseases such as osteoporosis are becoming more important because of an aging society in human medicine. These diseases increase the risk of fragility fracture as bone mineral levels decrease, and also reduces their quality of life. Previous studies have reported that bone strength and fracture risk are closely related to bone mineral density (BMD) [6,9,27]. In contrast, several studies have suggested that changes in bone architecture increase fracture risk [29,31,33,34,43]. Therefore, it is necessary to study the changes in both BMD and architecture for more sensitive investigation of the bone disease.Quantitative computed tomography (QCT) has been widely investigated and applied in recent years as a means of non-invasive quantification of BMD. It has been reported that QCT might be most sensitive to changes in bone density caused by rapid bone turnover, such as in menopausal immobilization or hyperthyroidism [9]. QCT can selectively measure both trabecular and cortical bone [9,13,22,38], and the BMD is expressed in milligrams per cubic centimeter (volumetric density) [9]. Ebbesen et al. showed highly correlation between BMD by QCT and compressive strength in the lumbar vertebrae [9].Several studies have reported that bone disorders such as osteoporosis lead to trabecular and cortical bone alterations in humans. These alterations are characterized not only by a reduction of bone mass but also by structural changes in microarchitecture which is measured by histomorphometry of bone [29,31,33]. Therefore, it has been considered that histomorphometric analysis have an important role as contributor to bone strength, in addition to BMD.Recently, miniature pig has been noticed as for experimental animal of bone study. The pig is an excel...

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Changes in Vertebral Bone Density in Black Girls and White Girls during Childhood and Puberty

Cited by 358 publications

References 21 publications

Quantitative CT Reference Values for Vertebral Trabecular Bone Density in Children and Young Adults

Quantitative CT Reference Values for Vertebral Trabecular Bone Density in Children and Young Adults

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

Age-Related Changes of Bone Mineral Density and Microarchitecture in Miniature Pigs

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