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The choice of normative pediatric reference database changes spine bone mineral density Z-scores but not the relationship between bone mineral density and prevalent vertebral fractures.
Ma, Jinhui; Siminoski, Kerry; Alos, Nathalie; Halton, Jacqueline; Ho, Josephine; Lentle, Brian; Matzinger, MaryAnn; Shenouda, Nazih; Atkinson, Stephanie; Barr, Ronald; Cabral, David A; Couch, Robert; Cummings, Elizabeth A; Fernandez, Conrad V; Grant, Ronald M; Rodd, Celia; Sbrocchi, Anne Marie; Scharke, Maya; Rauch, Frank; Ward, Leanne M.
Afiliación
  • Ma J; Children's Hospital of Eastern Ontario Research Institute (J.M., M.S.), Ottawa, ON; University of Alberta (K.S., R.C.), Edmonton, AB; Université de Montréal (N.A.), Montréal, QC; University of Ottawa (J.H., M.M., N.S., L.M.W.), Ottawa, ON; University of Calgary (J.H.), Calgary, AB; University of British Columbia (B.L., D.A.C.), Vancouver, BC; McMaster University (S.A., R.B.), Hamilton, ON; Dalhousie University (E.A.C., C.V.F.), Halifax, NS; University of Toronto (R.M.G.), Toronto, ON; University
J Clin Endocrinol Metab ; 100(3): 1018-27, 2015 Mar.
Article en En | MEDLINE | ID: mdl-25494661
OBJECTIVES: Our objectives were to assess the magnitude of the disparity in lumbar spine bone mineral density (LSBMD) Z-scores generated by different reference databases and to evaluate whether the relationship between LSBMD Z-scores and vertebral fractures (VF) varies by choice of database. PATIENTS AND DESIGN: Children with leukemia underwent LSBMD by cross-calibrated dual-energy x-ray absorptiometry, with Z-scores generated according to Hologic and Lunar databases. VF were assessed by the Genant method on spine radiographs. Logistic regression was used to assess the association between fractures and LSBMD Z-scores. Net reclassification improvement and area under the receiver operating characteristic curve were calculated to assess the predictive accuracy of LSBMD Z-scores for VF. RESULTS: For the 186 children from 0 to 18 years of age, 6 different age ranges were studied. The Z-scores generated for the 0 to 18 group were highly correlated (r ≥ 0.90), but the proportion of children with LSBMD Z-scores ≤-2.0 among those with VF varied substantially (from 38-66%). Odds ratios (OR) for the association between LSBMD Z-score and VF were similar regardless of database (OR = 1.92, 95% confidence interval 1.44, 2.56 to OR = 2.70, 95% confidence interval 1.70, 4.28). Area under the receiver operating characteristic curve and net reclassification improvement ranged from 0.71 to 0.75 and -0.15 to 0.07, respectively. CONCLUSIONS: Although the use of a LSBMD Z-score threshold as part of the definition of osteoporosis in a child with VF does not appear valid, the study of relationships between BMD and VF is valid regardless of the BMD database that is used.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Absorciometría de Fotón / Densidad Ósea / Bases de Datos Factuales / Fracturas de la Columna Vertebral Tipo de estudio: Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Clin Endocrinol Metab Año: 2015 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Absorciometría de Fotón / Densidad Ósea / Bases de Datos Factuales / Fracturas de la Columna Vertebral Tipo de estudio: Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: J Clin Endocrinol Metab Año: 2015 Tipo del documento: Article Pais de publicación: Estados Unidos