Revised pediatric reference data for the lateral distal femur measured by Hologic Discovery/Delphi dual-energy X-ray absorptiometry.
Revised pediatric reference data for the lateral distal femur measured by Hologic Discovery/Delphi dual-energy X-ray absorptiometry.
复制标题
通过全息发现/Delphi双能X射线吸收测定法测量的修订后股骨远端股骨的修订小儿参考数据。
DOI：
10.1016/j.jocd.2009.01.005
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发表时间：
2009-04
期刊：
影响因子：
--
通讯作者：
Henderson RC
中科院分区：
文献类型：
--
作者：
Zemel BS;Stallings VA;Leonard MB;Paulhamus DR;Kecskemethy HH;Harcke HT;Henderson RC
双能x线吸收仪（DXA）的外侧股骨远端（LDF）扫描在其他部位无法测量的儿童中通常是可行的。最近的DXA技术还没有关于LDF的儿科参考数据。为了评估老年儿童LDF参考数据，构建新的LDF骨矿物质密度（BMD）参考曲线，并证明LDF BMD与DXA和外周定量计算机断层扫描（pQCT）评估的其他BMD和强度指标的可比性。使用Hologic Delphi/Discovery系统获得了在单个中心招募的821名5至18岁健康儿童的LDF、脊柱和全身扫描。采用pQCT评估胫骨骨小梁和总骨密度（3%部位）、皮质几何形状（38%部位）（皮质厚度、截面模量、应变强度指数）。使用LMS-ChartMaker生成性别和种族特异性参考曲线，并通过相关分析计算和比较z分数。根据已发表的研究结果，LDF骨密度的z分数显示了对低年龄骨密度患病率的高估或低估，这取决于所考虑的兴趣区域。生成修订后的LDF参考曲线。新的LDF z -评分与体重、BMI、脊柱和全身BMD z -评分以及所有pQCT z -评分呈显著相关性。这些发现证明了LDF测量与其他临床和研究骨密度评估模式的可比性，并使残疾儿童的骨密度评估成为可能，这些儿童特别容易发生长骨的低创伤性骨折，传统的DXA测量点对他们来说是不可行的。
Lateral distal femur (LDF) scans by dual energy x-ray absorptiometry (DXA) are often feasible in children for whom other sites are not measurable. Pediatric reference data for LDF are not available for more recent DXA technology. To assess older pediatric LDF reference data, construct new reference curves for LDF bone mineral density (BMD), and demonstrate the comparability of LDF BMD to other measures of BMD and strength assessed by DXA and by peripheral quantitative computed tomography (pQCT). LDF, spine and whole body scans of 821 healthy children, 5 to 18 years of age, recruited at a single center were obtained using a Hologic Delphi/Discovery system. Tibia trabecular and total BMD (3% site), cortical geometry (38% site) (cortical thickness, section modulus, strain strength index) were assessed by pQCT. Sex and race-specific reference curves were generated using LMS-ChartMaker and Z-scores calculated and compared by correlation analysis. Z-scores for LDF BMD based on published findings demonstrated overestimation or underestimation of the prevalence of low BMD-for-age depending on the region of interest considered. Revised LDF reference curves were generated. The new LDF Z-scores were strongly and significantly associated with weight, BMI, spine and whole body BMD Z-scores, and all pQCT Z-scores. These findings demonstrate the comparability of LDF measurements to other clinical and research bone density assessment modes, and enable assessment of BMD in children with disabilities, who are particularly prone to low trauma fractures of long bones, and for whom traditional DXA measurement sites are not feasible.