Is the skull responsive to bone mineralisation stimuli in children?
Is the skull responsive to bone mineralisation stimuli in children?
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DOI：
10.1016/j.bone.2022.116415
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发表时间：
2022-04-12
期刊：
影响因子：
4.1
通讯作者：
Harvey, Nicholas C.
中科院分区：
文献类型：
--
作者：
Moon, Rebecca J.;D'Angelo, Stefania;Harvey, Nicholas C.
背景资料：全身无头（WBLH）是双能X线骨密度仪（DXA）评估儿童骨密度（BMD）的推荐骨骼感兴趣区（ROI）。从历史上看，头骨对影响BMD的刺激的反应不如骨骼的其他部分，但很少有发表的数据支持这一观点。我们比较了BMD与人体测量、身体成分、饮食和活动变量在不同ROI中的相关性。研究方法：来自南安普顿妇女调查（SWS）的母亲-子女队列的儿童在6-7岁时参与，包括通过DXA（Hologic Discovery）测量身高、体重和全身和腰椎（LS）BMD。体力活动通过加速度计（Actiheart）进行评估，饮食通过访谈者引导的问卷进行评估。在以下骨骼ROI中测量BMD：全身、颅骨、WBLH和下肢（均来自全身扫描）和LS。结果：1218名儿童参与。身高Z分数、体重Z分数、瘦体重和牛奶摄入量与颅骨BMD相关，但相关性弱于其他ROI;例如，瘦体重和颅骨BMD之间的相关性为β（95%CI）0.11（0.08，0.14）SD/kg，而全身、WBLH和腰椎分别为0.32（0.30，0.34）、0.38（0.37，0.40）和0.23（0.21，0.25）SD/kg。与WBLH相比，与全身BMD的关系减弱。结论：颅骨BMD和人体测量，身体成分和饮食变量之间的关联弱于其他DXA网站。这些研究结果支持，重要的是提供了一个定量的基础，建议颅骨应排除在全身DXA分析的儿童。
Background: Whole-body-less-head (WBLH) is the recommended skeletal region of interest (ROI) for dual-energy X-ray absorptiometry (DXA) assessment of bone mineral density (BMD) in children. Historically it has been suggested that the skull is less responsive than the rest of the skeleton to stimuli that affect BMD but there are few published data to support this notion. We compared the associations of BMD with anthropometric, body composition, diet, and activity variables across various ROI. Methods: Children from the Southampton Women's Survey (SWS) mother-offspring cohort participated at age 6-7 years, including measurement of height, weight, and whole-body and lumbar spine (LS) BMD by DXA (Hologic Discovery). Physical activity was assessed by accelerometry (Actiheart) and diet by interviewer-led questionnaire. BMD was measured in the following skeletal ROI: whole-body, skull, WBLH and lower limbs (all derived from the whole-body scan) and LS. Results: 1218 children participated. Height z-score, weight z-score, lean mass and milk intake were associated with skull BMD, but associations were weaker than observed for other ROI; for example, the association between lean mass and skull BMD was beta (95% CI) 0.11 (0.08, 0.14) SD/kg, compared with 0.32 (0.30, 0.34), 0.38 (0.37, 0.40) and 0.23 (0.21, 0.25) SD/kg for whole body, WBLH and lumbar spine, respectively. Relationships with whole-body BMD were attenuated compared with WBLH. Conclusion: Associations between skull BMD and anthropometry, body composition and dietary variables were weaker than for other DXA sites. These findings support, and importantly provide a quantitative basis for, the recommendation that the skull should be excluded from whole-body DXA analyses in children.