Baseline Developed for Bone Density
A new study led by Cincinnati Children's Hospital Medical Center researchers is providing pediatricians with a practical tool to help determine whether children with chronic diseases are at increased risk for bone mass deficiencies, fracture or osteoporosis. Based on data from this study, pediatricians now have at their disposal the first bone-growth guide, similar to height-and-weight charts, for evaluating children at high risk of bone problems.
"There is a huge demand for this information among clinicians because almost any chronic condition in children that affects growth, involves inflammation, or among cancer survivors, increases likelihood of poor bone mass accrual," said Heidi Kalkwarf, PhD, associate professor of General and Community Pediatrics at Cincinnati Children's, and lead author of the research report. "The issue is you can't know there is a problem unless you know what is normal and part of our research focuses on identifying what is normal."
The study focused on gathering standardized data about accumulation of bone mass during childhood – a critical determinant of whether children are at elevated risk for fracture or osteoporosis, Dr. Kalkwarf said. The research findings will allow physicians to use standardized data on bone mass categorized by sex, age, and race – and formatted similar to a growth chart – as a screening tool to identify children with potential underlying problems in skeletal development.
In collecting their data, researchers conducted bone density scans on the spine, forearm, hip and whole body to establish reference data for these skeletal sites. This comprehensive evaluation of bone status will determine if certain conditions or treatments affect some skeletal sites differently from others.
Prior to this study, available bone density reference data were not optimal for evaluating the status of children because sample sizes were too small and standardized protocols were not used for including and measuring patients, Dr. Kalkwarf noted. As well, the collection and analysis of previous data were inconsistent and did not factor in variables for age, sex and race. These factors, taken along with chronic medical conditions, medications and lifestyle are important reference points affecting bone mineral accrual in children.
"Before this data it was like comparing apples to oranges," Dr. Kalkwarf said. "Now, pediatricians can monitor children according to the chart we developed and determine if they are normal or if there's something that needs to be investigated further."
The research was funded by and conducted under the auspices of the National Institute for Child Health and Human Development (NICHD) of the National Institutes of Health. The research report is published in the June edition of the Journal of Clinical Endocrinology and Metabolism.
