Amalgamated reference data for size-adjusted bone densitometry measurements in 3598 children and young adults – the ALPHABET study

Crabtree, N.J. et al. (2017) Amalgamated reference data for size-adjusted bone densitometry measurements in 3598 children and young adults – the ALPHABET study. Journal of Bone and Mineral Research, 32(1), pp. 172-180. (doi: 10.1002/jbmr.2935) (PMID:27490028)

Abstract

The increasing use of dual energy X-ray absorptiometry (DXA) in children has led to the need for robust reference data for interpretation of scans in daily clinical practice. Such data need to be representative of the population being studied and be ‘future-proofed’ to software and hardware upgrades. The aim was to combine all available paediatric DXA reference data from seven UK centres to create reference curves adjusted for age, sex, ethnicity and body size to enable clinical application, using in-vivo cross calibration and making data back- and forward- compatible. Seven UK sites collected data on GE-Lunar or Hologic Scanners between 1996 and 2012. Males and females aged 4 to 20 years were recruited (n = 3598). The split by ethnic group was: White Caucasian 2887; South Asian 385; Black Afro-Caribbean 286; mixed heritage 40. Scans of the total body and lumbar spine (L1-L4) were obtained. The European Spine Phantom was used to cross-calibrate the 7 centres and 11 scanners. Reference curves were produced for L1-L4 bone mineral apparent density (BMAD) and total body less head (TBLH) and L1-L4 areal bone mineral density (aBMD) for GE Lunar Prodigy and iDXA (sex-and ethnic-specific) and for Hologic (sex-specific). Regression equations for TBLH BMC were produced using stepwise linear regression. Scans of 100 children were randomly selected to test backwards and forwards compatibility of software versions, up to version 15.0 for GE Lunar, and Apex 4.0 for Hologic. For the first time, sex and ethnic- specific reference curves for lumbar spine BMAD, aBMD and TBLH aBMD are provided for both GE-Lunar and Hologic scanners. These curves will facilitate interpretation of DXA data in children using methods recommended in ISCD guidelines. The databases have been created to allow future updates and analysis when more definitive evidence for the best method of fracture prediction in children is agreed.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Ahmed, Professor Syed Faisal
• Authors: Crabtree, N.J., Shaw, N.J., Bishop, N.J., Adams, J.E., Mughal, M.Z., Arundel, P., Fewtrell, M.S., Ahmed, S.F., Treadgold, L.A., Högler, W., Bebbington, N.A., and Ward, K.A.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Journal of Bone and Mineral Research
• Publisher: Wiley
• ISSN: 0884-0431
• ISSN (Online): 1523-4681
• Published Online: 04 August 2016
• Copyright Holders: Copyright © 2016 American Society for Bone and Mineral Research
• First Published: First published in Journal of Bone and Mineral Research 32(1): 172-180
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher