Morris E Brannon, Shelso John, Smeltzer Matthew P, Thomas Nicole A, Karimova E Jane, Li Chin-Shang, Merchant Thomas, Gajjar Amar, Kaste Sue C
Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
Pediatr Radiol. 2008 Dec;38(12):1285-92. doi: 10.1007/s00247-008-0991-x. Epub 2008 Sep 4.
Skeletal bone accretion occurs throughout childhood. The integrity of this process can influence future adult bone health and the risk of osteoporosis. Although surveillance of children who are at risk of poor bone accretion is important, the most appropriate method to monitor childhood bone health has not been established. Previous investigators have proposed using bone age (BA) rather than chronological age (CA) when interpreting bone mineral density (BMD) values in children.
To investigate the value of BA assessment for BMD measurement in a cohort of children at risk of poor accretion.
A cohort of 163 children with brain tumors who completed both a BMD assessment (quantitative computed tomography, QCT) and who had a BA within a 6-month interval were identified. The difference in BMD Z-scores determined by CA and BA was determined. The impact of salient clinical features was assessed.
No significant difference between CA and BA Z-scores was detected in the overall cohort (P = 0.056). However, the scores in 18 children (all boys between the ages of 11 years and 15 years) were statistically determined to be outliers from the values in the rest of the cohort.
Interpretation of BMD with BA measurement might be appropriate and affect treatment decisions in peripubertal males.
儿童期骨骼持续生长。这一过程的完整性会影响未来成人的骨骼健康以及患骨质疏松症的风险。尽管监测骨骼生长不良风险儿童很重要，但尚未确定监测儿童骨骼健康的最合适方法。之前的研究人员建议，在解释儿童骨密度（BMD）值时使用骨龄（BA）而非实足年龄（CA）。
研究骨龄评估在一组骨骼生长不良风险儿童骨密度测量中的价值。
确定了一组163名脑肿瘤患儿，他们均完成了骨密度评估（定量计算机断层扫描，QCT），且在6个月内有骨龄数据。确定了根据实足年龄和骨龄得出的骨密度Z评分的差异。评估了显著临床特征的影响。
在整个队列中，实足年龄和骨龄的Z评分之间未检测到显著差异（P = 0.056）。然而，18名儿童（均为11至15岁的男孩）的评分经统计学判定为队列其他儿童值的异常值。
用骨龄测量来解释骨密度可能是合适的，并会影响青春期男性的治疗决策。
