Academic Journal
Pediatric densitometry: is the Z score adjustment necessary in all cases?
| Τίτλος: | Pediatric densitometry: is the Z score adjustment necessary in all cases? |
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| Συγγραφείς: | Berta Magallares, Jorge Malouf, Helena Codes-Méndez, Hye Sang Park, Jocelyn Betancourt, Gloria Fraga, Estefanía Quesada-Masachs, Mireia López-Corbeto, Montserrat Torrent, Ana Marín, Silvia Herrera, Ignasi Gich, Susana Boronat, Jordi Casademont, Hector Corominas, Dacia Cerdá |
| Συνεισφορές: | Institut Català de la Salut, [Magallares B] Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Department of Rheumatology, Universitari Dexeus-Grupo Quirón Salud Hospital, Barcelona, Spain. Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain. Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Malouf J] Department of Mineral Metabolism Unit - Internal Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. [Codes-Méndez H] Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain. [Park HS] Department of Rheumatology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain. Facultat de Medicina, Universitat Autònoma de Barcelona, Bellaterra, Spain. [Betancourt J, Fraga G] Institut de Recerca Sant Pau (IR SANT PAU), Barcelona, Spain. Department of Pediatrics, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain. [Quesada-Masachs E] Department of Rheumatology, Universitari Dexeus-Grupo Quirón Salud Hospital, Barcelona, Spain. Unitat de Reumatologia Pediàtrica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [López-Corbeto M] Unitat de Reumatologia Pediàtrica, Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus |
| Πηγή: | Front Endocrinol (Lausanne) Scientia Scientia. Dipòsit d'Informació Digital del Departament de Salut instname Frontiers in Endocrinology, Vol 16 (2025) |
| Στοιχεία εκδότη: | Frontiers Media SA, 2025. |
| Έτος έκδοσης: | 2025 |
| Θεματικοί όροι: | Male, DXA (dual-energy x-ray absorptiometry), Adolescent, NAMED GROUPS::Persons::Age Groups::Child, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::diagnóstico por imagen::radiografía::absorciometría fotónica, DENOMINACIONES DE GRUPOS::personas::Grupos de Edad::niño, Diseases of the endocrine glands. Clinical endocrinology, ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::trastornos del crecimiento, Young Adult, Endocrinology, Absorptiometry, Photon, Bone Density, Densitometria òssia, Trastorns del creixement, PHENOMENA AND PROCESSES::Musculoskeletal and Neural Physiological Phenomena::Musculoskeletal Physiological Phenomena::Bone Density, DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Growth Disorders, Humans, pediatric densitometry, Child, FENÓMENOS Y PROCESOS::fenómenos fisiológicos nerviosos y musculoesqueléticos::fenómenos fisiológicos musculoesqueléticos::densidad ósea, Growth Disorders, Retrospective Studies, Lumbar Vertebrae, height-for-age z-score, Otros calificadores::Otros calificadores::Otros calificadores::/diagnóstico por imagen, Other subheadings::Other subheadings::Other subheadings::/diagnostic imaging, low bone mineral mass, RC648-665, Body Height, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Imaging::Radiography::Absorptiometry, Photon, Child, Preschool, Female, Estatura, bone mineral density, Infants, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::exploración física::constitución corporal::pesos y medidas corporales::tamaño corporal::estatura corporal, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Physical Examination::Body Constitution::Body Weights and Measures::Body Size::Body Height |
| Περιγραφή: | BackgroundThe International Society for Clinical Densitometry recommends adjusting the bone mineral density (BMD) Z-score in children with short stature or growth delay. However, it is not clear whether height-for-age Z-score (HAZ) adjustment is required in all children. The aim of this study was to determine whether HAZ adjustment is necessary by examining variability in unadjusted and adjusted Z-scores for the main regions of interest in a large pediatric cohort.MethodsWe evaluated 103 patients ≤ 20 years of age who underwent lumbar spine and whole-body dual-energy x-ray absorptiometry (DXA) at our tertiary care hospital from 2016 to 2018. The formula proposed by Zemel was used to calculate the HAZ.ResultsA total of 103 participants were included (54 females; 52.4%). The mean age was 9.8 years. Height percentiles were ≤ 3 or ≥ 97 in seven (6.8%) and five (4.9%) patients. Diagnostic criteria for low bone mineral density (LBMD; BMD Z-score ≤ −2) were met in 8 lumbar spine scans and 10 whole-body scans. After HAZ adjustment, the prevalence of LBMD decreased from 8.2% (n=8) to 6.4% (n=6) in the lumbar spine scans and from 10.5% (n=10) to 7.2% (n=8) in the whole-body scans. Agreement between the adjusted and non-adjusted HAZ data was 0.498 for the lumbar spine and 0.557 for the whole body. The diagnostic discrepancy rate for LBMD diagnosis was 7%. After HAZ adjustment, 5% patients no longer met LBMD criteria while conversely 2% met LBMD criteria only after adjustment.ConclusionsThe high diagnostic discrepancy rate (7%) for LBMN in this unselected pediatric cohort underscores the value of performing HAZ adjustment of Z-scores to improve diagnostic accuracy. This divergence between adjusted and unadjusted Z-scores suggests that all pediatric patients, not only those with short stature or growth retardation, may benefit from densitometric size adjustment. This is especially true in individuals whose stature is at the upper end of the range, where size may obscure a diagnosis of LBMD. |
| Τύπος εγγράφου: | Article Other literature type |
| Περιγραφή αρχείου: | application/pdf |
| ISSN: | 1664-2392 |
| DOI: | 10.3389/fendo.2025.1587382 |
| Σύνδεσμος πρόσβασης: | https://pubmed.ncbi.nlm.nih.gov/40270717 http://hdl.handle.net/11351/13233 https://doaj.org/article/aa23ed90733a4786a1dc88498a9d2c34 |
| Rights: | CC BY |
| Αριθμός Καταχώρησης: | edsair.doi.dedup.....827036fc3763b1d0a758f79bcf37669c |
| Βάση Δεδομένων: | OpenAIRE |
| ISSN: | 16642392 |
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| DOI: | 10.3389/fendo.2025.1587382 |