Oza Chirantap, Khadilkar Anuradha, Goel Pranay, Karguppikar Madhura, Shah Nikhil, Lohiya Nikhil, Mondkar Shruti, Patil Prashant, Prasad Hemchand, Maheshwari Ankita, Ladkat Dipali, Kajale Neha, More Chidvilas, Khurjekar Devarati, Khadilkar Vaman
Department of Paediatric growth and Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India; Endogrow Pediatric and Adolescent Endocrine Centre, Ahmedabad, India; Department of Pediatrics, Narendra Modi Medical College, GCS Medical College and B.J. Medical College, Ahmedabad, India.
Department of Paediatric growth and Endocrinology, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India; Interdisciplinary School of Health Sciences, Savitribai Phule University, Pune, India.
Bone. 2023 Oct 28:116952. doi: 10.1016/j.bone.2023.116952.
BoneXpert (BX) performs digital radiogrammetry and reports metacarpal index (MCI) besides bone age (BA) evaluation. Its utility in subjects with type-1 diabetes (T1D) has not been reported. We conducted this study with following objectives: 1) To study the utility of BX in the assessment of BA in Indian children and youth (CY) with T1D and 2) To assess association of MCI (measured by BX) and bone health in Indian CY with T1D.
The MCI and BA were assessed retrospectively in 1272 subjects with T1D using digitalised left-hand x-rays. The demographic, anthropometric, clinical, dietary, biochemistry, dual x-ray absorptiometry (DXA) data and peripheral quantitative computed tomography (pQCT) data collection were performed using standard protocols and were extracted from hospital records.
The root mean square error of BX with respect to reference and true bone age by TW-3 method were estimated to be 0.72 years and 0.67 years respectively in Indian CY with T1D. The BX provided MCI results were in concordance with the DXA derived bone mineral density (r = 0.551) and pQCT derived cortical density (r = 0.318) measurements; MCI correlated with trabecular density at the tibia (r = 0.212). 51.5 % subjects with T1D had significantly decreased MCI. Height, tanner stage, vitamin D concentrations showed positive correlation while HbA1c and disease duration had negative correlation with MCI.
BX may be used for accurate assessment of BA by TW-3 method and for screening for bone health in Indian CY with T1D.
BoneXpert（BX）可进行数字放射测量，并在评估骨龄（BA）之外报告掌骨指数（MCI）。其在1型糖尿病（T1D）患者中的应用尚未见报道。我们开展本研究的目的如下：1）研究BX在评估印度T1D儿童和青少年（CY）骨龄方面的应用；2）评估印度T1D儿童和青少年中由BX测量的MCI与骨骼健康之间的关联。
使用数字化左手X线片对1272例T1D患者的MCI和BA进行回顾性评估。人口统计学、人体测量学、临床、饮食、生物化学、双能X线吸收法（DXA）数据以及外周定量计算机断层扫描（pQCT）数据收集均采用标准方案，并从医院记录中提取。
在印度T1D儿童和青少年中，BX相对于TW-3法参考骨龄和真实骨龄的均方根误差分别估计为0.72年和0.67年。BX提供的MCI结果与DXA得出的骨矿物质密度（r = 0.551）和pQCT得出的皮质骨密度（r = 0.318）测量结果一致；MCI与胫骨小梁密度相关（r = 0.212）。51.5%的T1D患者MCI显著降低。身高、坦纳分期、维生素D浓度与MCI呈正相关，而糖化血红蛋白（HbA1c）和病程与MCI呈负相关。
BX可用于通过TW-3法准确评估骨龄，并用于筛查印度T1D儿童和青少年的骨骼健康状况。
