Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Biostatistics, Shiraz University of Medical Sciences, Shiraz, Iran.
Arch Osteoporos. 2018 Nov 19;13(1):132. doi: 10.1007/s11657-018-0546-1.
Bone health evaluation in children requires an appropriate reference database. We have shown higher curves for spine aBMD in Iranian subjects than Americans, but lower curves for femoral neck and total body. These results can be used as reference values to assist Iranian clinicians in interpreting and monitoring bone densitometry results.
Bone health evaluation requires an appropriate reference database that can identify the bone deficit according to age, sex, puberty, and race. The aim of this study was to determine bone mineral density Z-scores in Iranian children and adolescents and their comparability with other reference data.
A sample of 476 healthy children and adolescents, aged 9-18 years, from Kawar (an urban community, 50 km east of Shiraz, Iran) was selected and bone mineral measurements of the lumbar spine, femoral neck, and total body (less head) were done. Sex-specific height-for-age, weight-for-age, and BMI-for-age Z-scores, as well as bone mineral density Z-scores, were calculated.
Extended reference curves for bone mineral content (BMC) and areal bone mineral density (aBMD) of the total body less head, lumbar spine, and femoral neck, for ages 9-18 years were constructed relative to sex and age. We found that median, - 2SD, and + 2SD curves for the lumbar spine aBMD were higher in Iranian subjects than in the American participants, but the curves of the femoral neck and total body were lower. Also, we showed that subjects with a lower height-for-age Z-score had a lower BMC and aBMD Z-score in the lumbar spine, femoral neck, and total body (p < 0.001).
Relevant differences in bone mineral density and its curves exist between Iranian children and adolescents and other databases, revealing a significant potential for misdiagnosis. However, our results can be used to provide reference databases to assist clinicians in interpreting, assessing, and monitoring bone densitometry.
儿童的骨骼健康评估需要一个合适的参考数据库。我们已经证明，伊朗受试者的脊柱 aBMD 曲线高于美国人，但股骨颈和全身的曲线较低。这些结果可以作为参考值，帮助伊朗临床医生解读和监测骨密度测定结果。
骨骼健康评估需要一个合适的参考数据库，该数据库可以根据年龄、性别、青春期和种族来识别骨骼缺陷。本研究的目的是确定伊朗儿童和青少年的骨密度 Z 分数，并比较其与其他参考数据的可比性。
从卡瓦尔（伊朗设拉子以东 50 公里的一个城市社区）抽取了 476 名 9-18 岁的健康儿童和青少年作为样本，对其腰椎、股骨颈和全身（不包括头部）进行了骨矿物质测量。计算了性别特异性的身高年龄、体重年龄和 BMI 年龄 Z 分数，以及骨矿物质密度 Z 分数。
构建了与性别和年龄相关的全身（不包括头部）、腰椎和股骨颈的骨矿物质含量（BMC）和面积骨矿物质密度（aBMD）的扩展参考曲线，年龄为 9-18 岁。我们发现，伊朗受试者的腰椎 aBMD 中位数、-2SD 和 +2SD 曲线均高于美国参与者，但股骨颈和全身的曲线较低。此外，我们还发现，身高年龄 Z 分数较低的受试者腰椎、股骨颈和全身的 BMC 和 aBMD Z 分数也较低（p<0.001）。
伊朗儿童和青少年的骨密度及其曲线与其他数据库存在明显差异，存在潜在的误诊风险。然而，我们的结果可以作为参考数据库，帮助临床医生解读、评估和监测骨密度测定结果。
