Skip to main content

Advertisement

SpringerLink
Log in

Body composition, energy expenditure and physical activity

Bone status measured by quantitative ultrasound: a comparison with DXA in Thai children

  • Original Article
  • Published:
European Journal of Clinical Nutrition Submit manuscript

Abstract

Background/Objectives:

Quantitative ultrasound (QUS) is used to measure bone quality and is known to be safe, radiation free and relatively inexpensive compared with dual-energy X-ray absorptiometry (DXA) that is considered the gold standard for bone status assessments. However, there is no consensus regarding the validity of QUS for measuring bone status. The aim of this study was to compare QUS and DXA in assessing bone status in Thai children.

Subjects/Methods:

A total of 181 Thai children (90 boys and 91 girls) aged 6 to 12 years were recruited. Bone status was measured by two different techniques in terms of the speed of sound (SOS) using QUS and bone mineral density (BMD) using DXA. Calcium intake was assessed by 24 h diet recall. Pearson’s correlation, κ-statistic and Bland and Altman analysis were used to assess the agreement between the methods.

Results:

There was no correlation between the two different techniques. Mean difference (s.d.) of the Z-scores of BMD and SOS was −0.61 (1.27) that was different from zero (P<0.05). Tertiles of Z-scores of BMD and QUS showed low agreement (κ 0.022, P=0.677) and the limits of agreement in Bland and Altman statistics were wide.

Conclusions:

Although QUS is easy and convenient to use, the SOS measurements at the radius seem not appropriate for assessing bone quality status.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Figure 1

Similar content being viewed by others

References

  1. Committee to Review Dietary Reference Intakes for Vitamin D and Calcium, Food and Nutrition Board, Institute of Medicine Dietary Reference Intakes for Calcium and Vitamin D. National Academy Press: Washington, DC, 2010.

  2. Pietrobelli A, Formica C, Wang Z-M, Heymsfield SB . Dual energy X-ray absorptiometry body composition model: review of physical concepts. Am J Physiol 1996; 271: E941–E951.

    CAS  Google Scholar 

  3. National Osteoporosis Society Bone Densitometry Techniques II: Single and Dual Energy X-ray Absorptiometry (cited 10 February 2015). Available from: https://www.nos.org.uk/document.doc?id=654.

  4. Watkins J . Structure and Function of the Musculoskeletal System, 2nd edn. Human Kinetics: Champaign, IL, USA, 2010.

    Google Scholar 

  5. Zittermann A, Gummert JF, Börgemann J . Vitamin D deficiency and mortality. Curr Opin Nutr Metab Care 2009; 12: 634–639.

    Article  CAS  Google Scholar 

  6. Prins SH, Jorgensen HL, Jorgensen LV, Hassager C . The role of quantitative ultrasound in the assessment of bone: review. Clin Physiol 1998; 18: 3–17.

    Article  CAS  Google Scholar 

  7. Krieg MA, Barkman R, Gannelli S, Stewart A, Bauer DC, Barquero LD et al. Quantitative ultrasound in the management of osteoporosis: the 2007 ISCD official position. J Clin Densitom 2008; 11: 163–187.

    Article  Google Scholar 

  8. Rojroongwasilkul N, Kijboonchoo K, Wimonpeerapattana W, Purttiponthanee S, Yamborisut U, Boonpraderm A et al. SEANUTS: the nutritional status and dietary intake of 0.5-12-year-old Thai children. Br J Nutr 2013; 110: S36–S44.

    Article  Google Scholar 

  9. Chailurkit LO, Aekplakorn W, Ongphiphadhanakul B . Regional variation and determinants of vitamin D status in sunshine-abundant Thailand. BMC Public Health 2011; 11: 853.

    Article  CAS  Google Scholar 

  10. EI-Desouki MI, Sherafzal MS, Othman SA . Comparison of bone mineral density with dual energy x-ray absorptiometry, quantitative ultrasound and single energy x-ray absorptiometry. Saudi Med J 2005; 26: 1346–1350.

    Google Scholar 

  11. De Onis M, Onyango AW, Borghi E, Siyam A, Nishida C, Siekmann J . Development of a WHO growth reference for school-aged-children and adolescents. Bull World Health Organ 2007; 85: 660–667.

    Article  Google Scholar 

  12. Gordon CM, Bachrach LK, Carpenter TO, Crabtree N, El-Hajj Fuleihan G, Kutilek S et al. Dual energy X-ray absorptiometry interpretation and reporting in children and adolescents: the 2007 ISCD pediatric official position. J Clin Densitom 2008; 11: 43–58.

    Article  Google Scholar 

  13. Bland JM, Altman DG . Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 116: 307–310.

    Article  Google Scholar 

  14. Du X, Greenfield H, Fraser DR, Ge K, Zheng W, Huang L et al. Low body weight and its association with bone health and pubertal maturation in Chinese girls. Eur J Clin Nutr 2003; 57: 693–700.

    Article  CAS  Google Scholar 

  15. Williams JE, Wilson CM, Biassoni L, Suri R, Fewtrell MS . Dual energy X-ray absorptiometry and quantitative ultrasound are not interchangeable in diagnosing abnormal bones. Arch Dis Child 2012; 97: 822–824.

    Article  CAS  Google Scholar 

  16. Christoforidis A, Economou M, Papadopoulou E, Kazantzidou E, Gompakis N, Athanassion-Metaxa M . Bone status of children with hemophilia a assessed with quantitative ultrasound sonography (QUS) and dual energy X-ray absorptiometry (DXA). J Pediatr Hematol Oncol 2010; 32: e259–e263.

    Article  Google Scholar 

  17. Christoforidis A, Perifanis V, Papadopoulou E, Dimitriadou M, Kazantzidou E, Vlachaki E et al. Poor correlations between measurements of bone quality by qualitative ultrasound sonography and dual energy X-ray absorptiometry in patients with β-thalassaemia major. Eur J Haematol 2008; 82: 15–21.

    Article  Google Scholar 

  18. Chong KH, Poh BK, Aini JN, Azmi KN, Deurenberg P . Radial quantitative ultrasound and dual energy X-ray absorptiometry: inter-method agreement for bone status assessment in children. Biomed Res Int 2015; 2015: 1–7.

    Google Scholar 

  19. Fielding KT, Nix DA, Bachrach LK . Comparison of calcaneus ultrasound and dual X-ray absorptiometry in children at risk of osteopenia. J Clin Densitom 2003; 6: 7–15.

    Article  Google Scholar 

  20. Jones G, Boon P . Which bone mass measures discriminate adolescents who have fractured from those who have not? Osteoporis Int 2008; 19: 251–255.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We are grateful to the children and their parents for their participation in this study. We also thank all staff at the Institute of Nutrition, Mahidol University, especially Kriyot Sudsa-ard, Rittirong Unjana and Petcharat Kunaphan for their help during the DXA measurements. Special thanks to the technicians of Golden Jubilee Medical Center, Mahidol University who were involved in the DXA measurements. FrieslandCampina, The Netherlands, sponsored the study.

Author contributions

WS and PD were responsible for the data analyses and reporting. WT, KK, NR and WW were closely involved in the data collection and NR, IK and PD were involved in the design of the study. All authors contributed to the manuscript writing.

Author information

Authors and Affiliations

  1. Institute of Nutrition, Mahidol University, Salaya Campus, Nakhon Pathom, Thailand

    W Srichan, W Thasanasuwan, K Kijboonchoo, N Rojroongwasinkul & W Wimonpeerapattana

  2. FrieslandCampina, Amersfoort, The Netherlands

    I Khouw

  3. Nutrition Consultant, Lighthouse Training & Consultancies, Langkawi, Malaysia

    P Deurenberg

Authors
  1. W Srichan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W Thasanasuwan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K Kijboonchoo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N Rojroongwasinkul
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. W Wimonpeerapattana
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. I Khouw
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. P Deurenberg
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to W Thasanasuwan.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Srichan, W., Thasanasuwan, W., Kijboonchoo, K. et al. Bone status measured by quantitative ultrasound: a comparison with DXA in Thai children. Eur J Clin Nutr 70, 894–897 (2016). https://doi.org/10.1038/ejcn.2015.180

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ejcn.2015.180

  • Springer Nature Limited

This article is cited by

Search

Navigation