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The Choice of Normative Pediatric Reference Database Changes Spine Bone Mineral Density Z-Scores But Not the Relationship Between Bone Mineral Density and Prevalent Vertebral Fractures

Objectives: Our objectives were to assess the magnitude of the disparity in lumbar spine bone mineral density (LSBMD) Z-scores generated by different reference databases and to evaluate whether the relationship between LSBMD Z-scores and vertebral fractures (VF) varies by choice of database. Patient... Full description

Journal Title: The journal of clinical endocrinology and metabolism 2015, Vol.100 (3), p.1018-1027
Main Author: Ma, Jinhui
Other Authors: Siminoski, Kerry , Alos, Nathalie , Halton, Jacqueline , Ho, Josephine , Lentle, Brian , Matzinger, MaryAnn , Shenouda, Nazih , Atkinson, Stephanie , Barr, Ronald , Cabral, David A , Couch, Robert , Cummings, Elizabeth A , Fernandez, Conrad V , Grant, Ronald M , Rodd, Celia , Sbrocchi, Anne Marie , Scharke, Maya , Rauch, Frank , Ward, Leanne M
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: United States: Endocrine Society
ID: ISSN: 0021-972X
Link: https://www.ncbi.nlm.nih.gov/pubmed/25494661
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recordid: cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4519277
title: The Choice of Normative Pediatric Reference Database Changes Spine Bone Mineral Density Z-Scores But Not the Relationship Between Bone Mineral Density and Prevalent Vertebral Fractures
format: Article
creator:
  • Ma, Jinhui
  • Siminoski, Kerry
  • Alos, Nathalie
  • Halton, Jacqueline
  • Ho, Josephine
  • Lentle, Brian
  • Matzinger, MaryAnn
  • Shenouda, Nazih
  • Atkinson, Stephanie
  • Barr, Ronald
  • Cabral, David A
  • Couch, Robert
  • Cummings, Elizabeth A
  • Fernandez, Conrad V
  • Grant, Ronald M
  • Rodd, Celia
  • Sbrocchi, Anne Marie
  • Scharke, Maya
  • Rauch, Frank
  • Ward, Leanne M
subjects:
  • Abridged Index Medicus
  • Absorptiometry, Photon - standards
  • Adolescent
  • Article
  • Bone Density
  • Bone mineral density Z-scores
  • Child
  • Child, Preschool
  • Choice Behavior
  • Databases, Factual
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Lumbar Vertebrae - diagnostic imaging
  • Lumbar Vertebrae - injuries
  • Male
  • Pediatric reference databases
  • Prevalence
  • Prevalent vertebral fractures
  • Reference Values
  • Research Design
  • ROC Curve
  • Spinal Fractures - diagnostic imaging
  • Spinal Fractures - epidemiology
ispartof: The journal of clinical endocrinology and metabolism, 2015, Vol.100 (3), p.1018-1027
description: Objectives: Our objectives were to assess the magnitude of the disparity in lumbar spine bone mineral density (LSBMD) Z-scores generated by different reference databases and to evaluate whether the relationship between LSBMD Z-scores and vertebral fractures (VF) varies by choice of database. Patients and Design: Children with leukemia underwent LSBMD by cross-calibrated dual-energy x-ray absorptiometry, with Z-scores generated according to Hologic and Lunar databases. VF were assessed by the Genant method on spine radiographs. Logistic regression was used to assess the association between fractures and LSBMD Z-scores. Net reclassification improvement and area under the receiver operating characteristic curve were calculated to assess the predictive accuracy of LSBMD Z-scores for VF. Results: For the 186 children from 0 to 18 years of age, 6 different age ranges were studied. The Z-scores generated for the 0 to 18 group were highly correlated (r ≥ 0.90), but the proportion of children with LSBMD Z-scores ≤−2.0 among those with VF varied substantially (from 38–66%). Odds ratios (OR) for the association between LSBMD Z-score and VF were similar regardless of database (OR = 1.92, 95% confidence interval 1.44, 2.56 to OR = 2.70, 95% confidence interval 1.70, 4.28). Area under the receiver operating characteristic curve and net reclassification improvement ranged from 0.71 to 0.75 and −0.15 to 0.07, respectively. Conclusions: Although the use of a LSBMD Z-score threshold as part of the definition of osteoporosis in a child with VF does not appear valid, the study of relationships between BMD and VF is valid regardless of the BMD database that is used.
language: eng
source:
identifier: ISSN: 0021-972X
fulltext: no_fulltext
issn:
  • 0021-972X
  • 1945-7197
url: Link


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titleThe Choice of Normative Pediatric Reference Database Changes Spine Bone Mineral Density Z-Scores But Not the Relationship Between Bone Mineral Density and Prevalent Vertebral Fractures
creatorMa, Jinhui ; Siminoski, Kerry ; Alos, Nathalie ; Halton, Jacqueline ; Ho, Josephine ; Lentle, Brian ; Matzinger, MaryAnn ; Shenouda, Nazih ; Atkinson, Stephanie ; Barr, Ronald ; Cabral, David A ; Couch, Robert ; Cummings, Elizabeth A ; Fernandez, Conrad V ; Grant, Ronald M ; Rodd, Celia ; Sbrocchi, Anne Marie ; Scharke, Maya ; Rauch, Frank ; Ward, Leanne M
creatorcontribMa, Jinhui ; Siminoski, Kerry ; Alos, Nathalie ; Halton, Jacqueline ; Ho, Josephine ; Lentle, Brian ; Matzinger, MaryAnn ; Shenouda, Nazih ; Atkinson, Stephanie ; Barr, Ronald ; Cabral, David A ; Couch, Robert ; Cummings, Elizabeth A ; Fernandez, Conrad V ; Grant, Ronald M ; Rodd, Celia ; Sbrocchi, Anne Marie ; Scharke, Maya ; Rauch, Frank ; Ward, Leanne M ; Canadian STOPP Consortium
descriptionObjectives: Our objectives were to assess the magnitude of the disparity in lumbar spine bone mineral density (LSBMD) Z-scores generated by different reference databases and to evaluate whether the relationship between LSBMD Z-scores and vertebral fractures (VF) varies by choice of database. Patients and Design: Children with leukemia underwent LSBMD by cross-calibrated dual-energy x-ray absorptiometry, with Z-scores generated according to Hologic and Lunar databases. VF were assessed by the Genant method on spine radiographs. Logistic regression was used to assess the association between fractures and LSBMD Z-scores. Net reclassification improvement and area under the receiver operating characteristic curve were calculated to assess the predictive accuracy of LSBMD Z-scores for VF. Results: For the 186 children from 0 to 18 years of age, 6 different age ranges were studied. The Z-scores generated for the 0 to 18 group were highly correlated (r ≥ 0.90), but the proportion of children with LSBMD Z-scores ≤−2.0 among those with VF varied substantially (from 38–66%). Odds ratios (OR) for the association between LSBMD Z-score and VF were similar regardless of database (OR = 1.92, 95% confidence interval 1.44, 2.56 to OR = 2.70, 95% confidence interval 1.70, 4.28). Area under the receiver operating characteristic curve and net reclassification improvement ranged from 0.71 to 0.75 and −0.15 to 0.07, respectively. Conclusions: Although the use of a LSBMD Z-score threshold as part of the definition of osteoporosis in a child with VF does not appear valid, the study of relationships between BMD and VF is valid regardless of the BMD database that is used.
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subjectAbridged Index Medicus ; Absorptiometry, Photon - standards ; Adolescent ; Article ; Bone Density ; Bone mineral density Z-scores ; Child ; Child, Preschool ; Choice Behavior ; Databases, Factual ; Female ; Humans ; Infant ; Infant, Newborn ; Lumbar Vertebrae - diagnostic imaging ; Lumbar Vertebrae - injuries ; Male ; Pediatric reference databases ; Prevalence ; Prevalent vertebral fractures ; Reference Values ; Research Design ; ROC Curve ; Spinal Fractures - diagnostic imaging ; Spinal Fractures - epidemiology
ispartofThe journal of clinical endocrinology and metabolism, 2015, Vol.100 (3), p.1018-1027
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1Copyright © 2015 by The Endocrine Society
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0Ma, Jinhui
1Siminoski, Kerry
2Alos, Nathalie
3Halton, Jacqueline
4Ho, Josephine
5Lentle, Brian
6Matzinger, MaryAnn
7Shenouda, Nazih
8Atkinson, Stephanie
9Barr, Ronald
10Cabral, David A
11Couch, Robert
12Cummings, Elizabeth A
13Fernandez, Conrad V
14Grant, Ronald M
15Rodd, Celia
16Sbrocchi, Anne Marie
17Scharke, Maya
18Rauch, Frank
19Ward, Leanne M
20Canadian STOPP Consortium
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0The Choice of Normative Pediatric Reference Database Changes Spine Bone Mineral Density Z-Scores But Not the Relationship Between Bone Mineral Density and Prevalent Vertebral Fractures
1The journal of clinical endocrinology and metabolism
addtitleJ Clin Endocrinol Metab
descriptionObjectives: Our objectives were to assess the magnitude of the disparity in lumbar spine bone mineral density (LSBMD) Z-scores generated by different reference databases and to evaluate whether the relationship between LSBMD Z-scores and vertebral fractures (VF) varies by choice of database. Patients and Design: Children with leukemia underwent LSBMD by cross-calibrated dual-energy x-ray absorptiometry, with Z-scores generated according to Hologic and Lunar databases. VF were assessed by the Genant method on spine radiographs. Logistic regression was used to assess the association between fractures and LSBMD Z-scores. Net reclassification improvement and area under the receiver operating characteristic curve were calculated to assess the predictive accuracy of LSBMD Z-scores for VF. Results: For the 186 children from 0 to 18 years of age, 6 different age ranges were studied. The Z-scores generated for the 0 to 18 group were highly correlated (r ≥ 0.90), but the proportion of children with LSBMD Z-scores ≤−2.0 among those with VF varied substantially (from 38–66%). Odds ratios (OR) for the association between LSBMD Z-score and VF were similar regardless of database (OR = 1.92, 95% confidence interval 1.44, 2.56 to OR = 2.70, 95% confidence interval 1.70, 4.28). Area under the receiver operating characteristic curve and net reclassification improvement ranged from 0.71 to 0.75 and −0.15 to 0.07, respectively. Conclusions: Although the use of a LSBMD Z-score threshold as part of the definition of osteoporosis in a child with VF does not appear valid, the study of relationships between BMD and VF is valid regardless of the BMD database that is used.
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8Choice Behavior
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16Male
17Pediatric reference databases
18Prevalence
19Prevalent vertebral fractures
20Reference Values
21Research Design
22ROC Curve
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24Spinal Fractures - epidemiology
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4Ho, Josephine
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7Shenouda, Nazih
8Atkinson, Stephanie
9Barr, Ronald
10Cabral, David A
11Couch, Robert
12Cummings, Elizabeth A
13Fernandez, Conrad V
14Grant, Ronald M
15Rodd, Celia
16Sbrocchi, Anne Marie
17Scharke, Maya
18Rauch, Frank
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titleThe Choice of Normative Pediatric Reference Database Changes Spine Bone Mineral Density Z-Scores But Not the Relationship Between Bone Mineral Density and Prevalent Vertebral Fractures
authorMa, Jinhui ; Siminoski, Kerry ; Alos, Nathalie ; Halton, Jacqueline ; Ho, Josephine ; Lentle, Brian ; Matzinger, MaryAnn ; Shenouda, Nazih ; Atkinson, Stephanie ; Barr, Ronald ; Cabral, David A ; Couch, Robert ; Cummings, Elizabeth A ; Fernandez, Conrad V ; Grant, Ronald M ; Rodd, Celia ; Sbrocchi, Anne Marie ; Scharke, Maya ; Rauch, Frank ; Ward, Leanne M
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0Abridged Index Medicus
1Absorptiometry, Photon - standards
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3Article
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5Bone mineral density Z-scores
6Child
7Child, Preschool
8Choice Behavior
9Databases, Factual
10Female
11Humans
12Infant
13Infant, Newborn
14Lumbar Vertebrae - diagnostic imaging
15Lumbar Vertebrae - injuries
16Male
17Pediatric reference databases
18Prevalence
19Prevalent vertebral fractures
20Reference Values
21Research Design
22ROC Curve
23Spinal Fractures - diagnostic imaging
24Spinal Fractures - epidemiology
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0Ma, Jinhui
1Siminoski, Kerry
2Alos, Nathalie
3Halton, Jacqueline
4Ho, Josephine
5Lentle, Brian
6Matzinger, MaryAnn
7Shenouda, Nazih
8Atkinson, Stephanie
9Barr, Ronald
10Cabral, David A
11Couch, Robert
12Cummings, Elizabeth A
13Fernandez, Conrad V
14Grant, Ronald M
15Rodd, Celia
16Sbrocchi, Anne Marie
17Scharke, Maya
18Rauch, Frank
19Ward, Leanne M
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0Ma, Jinhui
1Siminoski, Kerry
2Alos, Nathalie
3Halton, Jacqueline
4Ho, Josephine
5Lentle, Brian
6Matzinger, MaryAnn
7Shenouda, Nazih
8Atkinson, Stephanie
9Barr, Ronald
10Cabral, David A
11Couch, Robert
12Cummings, Elizabeth A
13Fernandez, Conrad V
14Grant, Ronald M
15Rodd, Celia
16Sbrocchi, Anne Marie
17Scharke, Maya
18Rauch, Frank
19Ward, Leanne M
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atitleThe Choice of Normative Pediatric Reference Database Changes Spine Bone Mineral Density Z-Scores But Not the Relationship Between Bone Mineral Density and Prevalent Vertebral Fractures
jtitleThe journal of clinical endocrinology and metabolism
addtitleJ Clin Endocrinol Metab
date2015-03
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notes
0This study was primarily funded by an operating grant from the Canadian Institutes for Health Research (FRN 64285). Additional funding for this work has been provided to L.W. by the Canadian Institutes for Health Research New Investigator Program, the Canadian Child Health Clinician Scientist Career Enhancement Program, a University of Ottawa Research Chair Award and the CHEO Departments of Pediatrics and Surgery. This work was also supported by the Children's Hospital of Eastern Ontario Research Institute and the University of Alberta Women and Children's Health Research Institute.
1On behalf of the Canadian STOPP Consortium, a national pediatric bone health working group
abstractObjectives: Our objectives were to assess the magnitude of the disparity in lumbar spine bone mineral density (LSBMD) Z-scores generated by different reference databases and to evaluate whether the relationship between LSBMD Z-scores and vertebral fractures (VF) varies by choice of database. Patients and Design: Children with leukemia underwent LSBMD by cross-calibrated dual-energy x-ray absorptiometry, with Z-scores generated according to Hologic and Lunar databases. VF were assessed by the Genant method on spine radiographs. Logistic regression was used to assess the association between fractures and LSBMD Z-scores. Net reclassification improvement and area under the receiver operating characteristic curve were calculated to assess the predictive accuracy of LSBMD Z-scores for VF. Results: For the 186 children from 0 to 18 years of age, 6 different age ranges were studied. The Z-scores generated for the 0 to 18 group were highly correlated (r ≥ 0.90), but the proportion of children with LSBMD Z-scores ≤−2.0 among those with VF varied substantially (from 38–66%). Odds ratios (OR) for the association between LSBMD Z-score and VF were similar regardless of database (OR = 1.92, 95% confidence interval 1.44, 2.56 to OR = 2.70, 95% confidence interval 1.70, 4.28). Area under the receiver operating characteristic curve and net reclassification improvement ranged from 0.71 to 0.75 and −0.15 to 0.07, respectively. Conclusions: Although the use of a LSBMD Z-score threshold as part of the definition of osteoporosis in a child with VF does not appear valid, the study of relationships between BMD and VF is valid regardless of the BMD database that is used.
copUnited States
pubEndocrine Society
pmid25494661
doi10.1210/jc.2014-3096
oafree_for_read