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A Pediatric Bone Mass Scan has Poor Ability to Predict Peak Bone Mass: An 11-Year Prospective Study in 121 Children

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Abstract

This 11-year prospective longitudinal study examined how a pre-pubertal pediatric bone mass scan predicts peak bone mass. We measured bone mineral content (BMC; g), bone mineral density (BMD; g/cm2), and bone area (cm2) in femoral neck, total body and lumbar spine by dual-energy X-ray absorptiometry in a population-based cohort including 65 boys and 56 girls. At baseline all participants were pre-pubertal with a mean age of 8 years (range 6–9), they were re-measured at a mean 11 years (range 10–12) later. The participants were then mean 19 years (range 18–19), an age range that corresponds to peak bone mass in femoral neck in our population. We calculated individual BMC, BMD, and bone size Z scores, using all participants at each measurement as reference and evaluated correlations between the two measurements. Individual Z scores were also stratified in quartiles to register movements between quartiles from pre-pubertal age to peak bone mass. The correlation coefficients (r) between pre-pubertal and young adulthood measurements for femoral neck BMC, BMD, and bone area varied between 0.37 and 0.65. The reached BMC value at age 8 years explained 42 % of the variance in the BMC peak value; the corresponding values for BMD were 31 % and bone area 14 %. Among the participants with femoral neck BMD in the lowest childhood quartile, 52 % had left this quartile at peak bone mass. A pediatric bone scan with a femoral neck BMD value in the lowest quartile had a sensitivity of 47 % [95 % confidence interval (CI) 28, 66] and a specificity of 82 % (95 % CI 72, 89) to identify individuals who would remain in the lowest quartile at peak bone mass. The pre-pubertal femoral neck BMD explained only 31 % of the variance in femoral neck peak bone mass. A pre-pubertal BMD scan in a population-based sample has poor ability to predict individuals who are at risk of low peak bone mass.

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Acknowledgments

Financial support was received from the Skåne University Hospital, the Österlund, Pahlsson, and Kock Foundations.

Conflict of Interest

Karlsson Caroline, Dencker Magnus, Nilsson Jan-Åke, and Karlsson K. Magnus have no potential conflicts of interest to report. Christian Buttazzoni and Rosengren E. Bjorn reports grant from Skåne University Hospital, the Österlund, Pahlsson, ALF, FoU and Kock Foundations, during the conduct of the study. The grant givers had no part in and no influence on the design or carrying out of neither the study nor the interpretation of results or writing of the manuscript.

Human and Animal Rights and Informed Consent

The study was conducted according to the Helsinki Declaration of 2000 and was approved by the Ethics Committee of Lund University (LU 453-98; September, 1998). Informed and written consent was obtained from parents or guardians of all participating children before study start.

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Authors and Affiliations

  1. Clinical and Molecular Osteoporosis Research Unit, Department of Orthopedics and Clinical Sciences, Skåne University Hospital, Lund University, 205 02, Malmō, Sweden

    Christian Buttazzoni, Bjorn E. Rosengren, Caroline Karlsson, Magnus Dencker, Jan-Åke Nilsson & Magnus K. Karlsson

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  1. Christian Buttazzoni
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  2. Bjorn E. Rosengren
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  3. Caroline Karlsson
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  5. Jan-Åke Nilsson
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  6. Magnus K. Karlsson
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Correspondence to Christian Buttazzoni.

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Buttazzoni, C., Rosengren, B.E., Karlsson, C. et al. A Pediatric Bone Mass Scan has Poor Ability to Predict Peak Bone Mass: An 11-Year Prospective Study in 121 Children. Calcif Tissue Int 96, 379–388 (2015). https://doi.org/10.1007/s00223-015-9965-9

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  • DOI: https://doi.org/10.1007/s00223-015-9965-9

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