Clinical Epidemiology Research Unit, Hospital Infantil de México Federico Gómez, Mexico; Universidad Nacional Autonoma de México, Mexico City, Mexico.
Childhood Nutrition Research Centre, Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, United Kingdom.
Bone. 2021 Jan;142:115734. doi: 10.1016/j.bone.2020.115734. Epub 2020 Nov 6.
Clinical assessment of bone health by Dual-Energy X-ray Absorptiometry (DXA) in the paediatric population requires robust reference values. The International Society for Clinical Densitometry (ISCD) recommends that country/regional reference values ideally should be used to improve precision in bone health assessment.
The aim of this study was to provide reference values for relevant bone health variables for healthy Mexican children and adolescents aged 5 to 18 years.
This was a cross-sectional, stratified and population-based study, that measured a representative sample of healthy Mexican children and adolescents with DXA. We constructed age- and sex-smoothed reference values for areal bone mineral density (aBMD) of total body less head (TBLH), total body (TB), lumbar spine (LS), and bone mineral apparent density (BMAD) for LS, by means of Generalized Additive Models for Location, Scale and Shape (GAMLSS).
Reference data including the 3th, 5th, 10th, 25th, 50th, 75th, 90th, 95th and 97th centiles, along with lambda (L), mu (M) and sigma (S) values, are given for each variable of interest for each sex at 0.25 years intervals. Reference values relative to height and Tanner-stage for both sexes are also provided. Finally, formulas to enable Z score estimation for clinical use are also presented CONCLUSIONS: The sex, age, height, Tanner-stage and ethnic-specific reference data provided in this study should enable more precise assessment of bone health in the Mexican paediatric population. The data presented may also allow for future evaluation of potential similarities and differences across different ethnic groups.
双能 X 射线吸收法（DXA）在儿科人群中进行骨健康临床评估需要可靠的参考值。国际临床密度测量学会（ISCD）建议，最好使用国家/地区参考值来提高骨健康评估的精度。
本研究旨在为 5 至 18 岁健康墨西哥儿童和青少年的相关骨健康变量提供参考值。
这是一项横断面、分层和基于人群的研究，使用 DXA 对健康的墨西哥儿童和青少年进行了代表性样本测量。我们通过广义加性模型进行了年龄和性别平滑的参考值构建位置、比例和形状（GAMLSS），用于总身体除头部（TBLH）、总身体（TB）、腰椎（LS）的面积骨矿物质密度（aBMD）和 LS 的骨矿物质表观密度（BMAD）。
包括第 3、5、10、25、50、75、90、95 和 97 百分位数在内的参考数据，以及 lambda（L）、mu（M）和 sigma（S）值，按性别给出，每 0.25 年间隔给出每个变量的参考数据。还提供了与身高和 Tanner 阶段有关的每个性别的参考值。最后，还提供了用于临床使用的 Z 分数估计的公式。
本研究提供的性别、年龄、身高、Tanner 阶段和种族特异性参考数据，应能更精确地评估墨西哥儿科人群的骨健康。所提供的数据还可能允许未来评估不同种族群体之间的潜在相似性和差异。
