Reference curves for trabecular bone score adjusted for soft tissue thickness in children and adolescents from Mexico City.

UNLABELLED

This study proposes age- and sex-specific trabecular bone score (TBS) reference curves for Mexican children and adolescents. Using the latest software version, results highlight significant pubertal changes and provide reference data for assessing pediatric bone health, paving the way for a wider use of this technology in children and adolescents.

PURPOSE

Trabecular Bone Score (TBS) is a grey scale texture measure that correlates with bone microarchitecture derived from dual-energy X-ray absorptiometry (DXA). While extensively studied in adults, limited data exist for pediatric populations. This study aims to develop age- and sex-specific reference curves for TBS adjusted for abdominal soft tissue thickness in healthy children and adolescents from Mexico City.

METHODS

This cross-sectional study reanalyzed data from 1552 healthy participants (5-18 years) who underwent lumbar spine DXA scans using Lunar iDXA and TBS iNsight 4.0 (Core Module 19.4.0), which accounts for soft tissue thickness. Generalized Additive Models for Location, Scale, and Shape (GAMLSS) were employed to construct smoothed percentile curves. TBS values were stratified by age, sex, and Tanner stage, with descriptive statistics and outlier exclusions.

RESULTS

TBS showed distinct age- and sex-related trajectories, with steep increases during puberty. Girls demonstrated a sharper rise in TBS starting at age 9, peaking by age 16, while boys exhibited a more gradual increase starting at age 10-11, peaking by age 18. Differences were also observed between Tanner stages, with the most significant changes occurring from stages 2 to 3.

CONCLUSION

This study proposes the first TBS reference curves for Mexican children and adolescents using the latest software version. This data may prove to be a valuable tool for assessing bone health in pediatric populations. Yet further research to explore TBS's utility in predicting bone fragility in pediatric population as well as its life-course trends.