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Amalgamated reference data for size-adjusted bone densitometry measurements in 3598 children and young adults - The alphabet study

Amalgamated reference data for size-adjusted bone densitometry measurements in 3598 children and young adults - The alphabet study
Amalgamated reference data for size-adjusted bone densitometry measurements in 3598 children and young adults - The alphabet study
The increasing use of dual-energy X-ray absorptiometry (DXA) in children has led to the need for robust reference data for interpretation of scans in daily clinical practice. Such data need to be representative of the population being studied and be “future-proofed” to software and hardware upgrades. The aim was to combine all available pediatric DXA reference data from seven UK centers to create reference curves adjusted for age, sex, ethnicity, and body size to enable clinical application, using in vivo cross-calibration and making data back and forward compatible. Seven UK sites collected data on GE Lunar or Hologic Scanners between 1996 and 2012. Males and females aged 4 to 20 years were recruited (n?=?3598). The split by ethnic group was white 2887; South Asian 385; black Afro-Caribbean 286; and mixed heritage 40. Scans of the total body and lumbar spine (L1 to L4) were obtained. The European Spine Phantom was used to cross-calibrate the 7 centers and 11 scanners. Reference curves were produced for L1 to L4 bone mineral apparent density (BMAD) and total body less head (TBLH) and L1 to L4 areal bone mineral density (aBMD) for GE Lunar Prodigy and iDXA (sex- and ethnic-specific) and for Hologic (sex-specific). Regression equations for TBLH BMC were produced using stepwise linear regression. Scans of 100 children were randomly selected to test backward and forward compatibility of software versions, up to version 15.0 for GE Lunar and Apex 4.1 for Hologic. For the first time, sex- and ethnic-specific reference curves for lumbar spine BMAD, aBMD, and TBLH aBMD are provided for both GE Lunar and Hologic scanners. These curves will facilitate interpretation of DXA data in children using methods recommended in ISCD guidelines. The databases have been created to allow future updates and analysis when more definitive evidence for the best method of fracture prediction in children is agreed.
0884-0431
1-9
Crabtree, N.J.
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Shaw, N.J.
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Bishop, N.J.
5e75c2ff-8269-4da5-b4eb-049aef2041ab
Adams, J.E.
a33a47cb-53dd-4f17-aebd-9dfff2485f97
Mughal, M.Z.
4858093f-9bb9-4521-87cd-d7463770d8c7
Arundel, P.
b7ab58c5-c958-40e1-886d-6db636714699
Fewtrell, M.S.
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Ahmed, S.F.
26cfa24d-4e2c-434b-b945-f33535f73553
Treadgold, L.A.
29d16ad1-d8c3-40b3-89ef-f35808d9a112
Hogler, W.
fd232c4e-50f9-4c21-a745-79b5f175f1de
Bebbington, N.A.
010af183-677b-46fe-9551-b432d2dacf09
Ward, K.A.
39bd4db1-c948-4e32-930e-7bec8deb54c7
Crabtree, N.J.
4243af9c-d274-474a-a5c1-4f2dbfc234d0
Shaw, N.J.
77a11d88-b295-445b-9e68-f307f7f4d4a6
Bishop, N.J.
5e75c2ff-8269-4da5-b4eb-049aef2041ab
Adams, J.E.
a33a47cb-53dd-4f17-aebd-9dfff2485f97
Mughal, M.Z.
4858093f-9bb9-4521-87cd-d7463770d8c7
Arundel, P.
b7ab58c5-c958-40e1-886d-6db636714699
Fewtrell, M.S.
e2c8e5d9-c99e-452e-bbe6-2b6bd6a63acf
Ahmed, S.F.
26cfa24d-4e2c-434b-b945-f33535f73553
Treadgold, L.A.
29d16ad1-d8c3-40b3-89ef-f35808d9a112
Hogler, W.
fd232c4e-50f9-4c21-a745-79b5f175f1de
Bebbington, N.A.
010af183-677b-46fe-9551-b432d2dacf09
Ward, K.A.
39bd4db1-c948-4e32-930e-7bec8deb54c7

Crabtree, N.J., Shaw, N.J., Bishop, N.J., Adams, J.E., Mughal, M.Z., Arundel, P., Fewtrell, M.S., Ahmed, S.F., Treadgold, L.A., Hogler, W., Bebbington, N.A. and Ward, K.A. (2016) Amalgamated reference data for size-adjusted bone densitometry measurements in 3598 children and young adults - The alphabet study. Journal of Bone and Mineral Research, 1-9. (doi:10.1002/jbmr.2935). (PMID:27490028)

Record type: Article

Abstract

The increasing use of dual-energy X-ray absorptiometry (DXA) in children has led to the need for robust reference data for interpretation of scans in daily clinical practice. Such data need to be representative of the population being studied and be “future-proofed” to software and hardware upgrades. The aim was to combine all available pediatric DXA reference data from seven UK centers to create reference curves adjusted for age, sex, ethnicity, and body size to enable clinical application, using in vivo cross-calibration and making data back and forward compatible. Seven UK sites collected data on GE Lunar or Hologic Scanners between 1996 and 2012. Males and females aged 4 to 20 years were recruited (n?=?3598). The split by ethnic group was white 2887; South Asian 385; black Afro-Caribbean 286; and mixed heritage 40. Scans of the total body and lumbar spine (L1 to L4) were obtained. The European Spine Phantom was used to cross-calibrate the 7 centers and 11 scanners. Reference curves were produced for L1 to L4 bone mineral apparent density (BMAD) and total body less head (TBLH) and L1 to L4 areal bone mineral density (aBMD) for GE Lunar Prodigy and iDXA (sex- and ethnic-specific) and for Hologic (sex-specific). Regression equations for TBLH BMC were produced using stepwise linear regression. Scans of 100 children were randomly selected to test backward and forward compatibility of software versions, up to version 15.0 for GE Lunar and Apex 4.1 for Hologic. For the first time, sex- and ethnic-specific reference curves for lumbar spine BMAD, aBMD, and TBLH aBMD are provided for both GE Lunar and Hologic scanners. These curves will facilitate interpretation of DXA data in children using methods recommended in ISCD guidelines. The databases have been created to allow future updates and analysis when more definitive evidence for the best method of fracture prediction in children is agreed.

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Accepted/In Press date: 2 August 2016
e-pub ahead of print date: 4 August 2016
Organisations: Faculty of Medicine

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Local EPrints ID: 402194
URI: http://eprints.soton.ac.uk/id/eprint/402194
ISSN: 0884-0431
PURE UUID: 31571f55-c4f4-4295-a3a3-cbd7df9ed45f
ORCID for K.A. Ward: ORCID iD orcid.org/0000-0001-7034-6750

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Date deposited: 03 Nov 2016 14:20
Last modified: 07 Oct 2020 04:19

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Contributors

Author: N.J. Crabtree
Author: N.J. Shaw
Author: N.J. Bishop
Author: J.E. Adams
Author: M.Z. Mughal
Author: P. Arundel
Author: M.S. Fewtrell
Author: S.F. Ahmed
Author: L.A. Treadgold
Author: W. Hogler
Author: N.A. Bebbington
Author: K.A. Ward ORCID iD

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