Abstract
Dual energy x-ray absorptiometry (DXA) of the lumbar spine (LS) was measured in 201 singleton infants with birth weights from 1152 to 3970 g and gestational ages from 27 to 42 wk. All infants were well and studied at a mean (±SD) of 2.1 (±1.6) days after birth. There were 75 Caucasian (46 males, 29 females) and 126 African American infants (58 males, 68 females). Scan acquisition of the first to fourth lumbar vertebrae was performed with a single beam whole body scanner (Hologic QDR 1000/W densitometer, Hologic Inc, Waltham, MA, U.S.A.) using the infant spine mode. Scan analysis was performed with software version 4.57Q and consistent region of interest. The SD of difference for duplicate LS scans is <1.4% at a mean bone mineral content (BMC) of 2.14 g. Results show that LS BMC, area, bone mineral density (BMD) increased by approximately 550%, 280% and 180%, respectively, between 27 and 42 wk gestational age. Body mass accounted for about 70% and 55% of the variance in BMC and BMD respectively. In contrast, the infant's length appears to be the best determinant of LS area and accounts for about 75% of the variance in LS area. Race, gender or season has little or no effect on LS bone mass. There was progressive increase in BMC and area from first to fourth lumbar vertebra but BMD was significantly higher only at the fourth lumbar vertebra. We conclude that DXA LS can be performed even in small preterm infants. Its excellent precision, low radiation exposure and rapid scan acquisition offers promise as a useful tool for widespread use in pediatrics. Our data may be used as a basis for further studies in physiologic and pathologic situations that may affect bone mineralization in infants.
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Abbreviations
- DXA:
-
dual energy x-ray absorptiometry
- LS:
-
lumbar spine
- BMC:
-
bone mineral content
- BMD:
-
bone mineral density
References
Koo WWK, Massom LR, Walters J 1995 Validation of accuracy and precision of dual energy x-ray absorptiometry for infants. J Bone Mineral Res 10: 1111–1115
Picaud JC, Rigo J, Nyamugabo K, Milet J, Senterre J 1996 Evaluation of dual energy X ray absorptiometry for body composition assessment in piglets and term human neonates. Am J Clin Nutr 63: 157–163
Braillon PM, Salle BL, Brunet J, Glorieux FH, Delmas PD, Meunier PJ 1992 Dual energy X-ray absorptiometry measurement of bone mineral content in newborns: Validation of the technique. Pediatr Res 32: 77–80
Koo WWK, Walters J, Bush AJ, Chesney RW, Carlson SE 1996 Dual energy x-ray absorptiometry studies of bone mineral status in newborn infants. J Bone Mineral Res 11: 997–1002
Koo WWK, Bush AJ, Walters J, Carlson SE 1998 Postnatal development of bone mineral status during infancy. J Am Coll Nutr 17: 65–70
Brenner WE, Edelman DA, Hendricks CH 1976 A standard of fetal growth for the United States of America. Am J Obstet Gynecol 126: 555–564
Ballard JL, Khoury JC, Wedig K, Wang L, Eilers-Walsman BL, Lipp R 1991 New Ballard score, expanded to include extremely premature infants. J Pediatr 119: 417–423
Bland JM, Altman DG 1986 Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1: 307–310
Koo WWK, Walters J, Bush AJ 1995 Technical considerations of dual energy x-ray absorptiometry-based bone mineral measurements for pediatric studies. J Bone Mineral Res 10: 1998–2004
Horwitz EM, Prockop DJ, Fitzpatrick LA, Koo WW, Gordon PL, Neel M, Sussman M, Orchard P, Marx JC, Pyeritz RE, Brenner MK 1999 Transplantability and therapeutic effects of bone marrow-derived mesenchymal cells in children with osteogenesis imperfecta. Nature Med 5: 309–313
Koo WWK, Steichen JJ 1998 Osteopenia and Rickets of Prematurity. In Polin R, Fox W (eds), Fetal and Neonatal physiology, 2nd Ed. W.B. Saunders Company, Philadelphia, pp 2335–2349
Nelson DA, Koo WWK 1999 Interpretation of absorptiometric bone mass measurements in the growing skeleton: issues and limitations. Calcif Tissue Int 65: 1–3
Prentice A, Parsons TJ, Cole TJ 1994 Uncritical use of bone mineral density in absorptiometry may lead to size-related artifacts in the identification of bone mineral determinants. Am J Clin Nutr 60: 837–842
Trotter M, Hixon BB 1974 Sequential changes in weight, density, and percentage ash weight of human skeletons from an early fetal period through old age. Anat Rec 179: 1–18
Namgung R, Tsang RC, Specker BL, Sierra RI, Ho ML 1994 Low bone mineral content and high serum osteocalcin and 1,25-dihydroxyvitamin D in summer- versus winter-born newborn infants: An early fetal effect?. J Pediatr Gastroenterol Nutr 19: 220
Gilsanz V, Roe TF, Mora S, Costin G, Goodman WG 1991 Changes in vertebral bone density in black girls and white girls during childhood and puberty. N Engl J Med 325: 1597–1600
Ortiz O, Russell M, Daley TL, Baumgartner RN, Waki M, Lichtman S, Wang J, Pierson RN, Heymsfield SB 1992 Differences in skeletal muscle and bone mineral mass between black and white females and their relevance to estimates of body composition. Am J Clin Nutr 55: 8–13
Bonjour JP, Theintz G, Buchs B, Slosman D, Rizzoli R 1991 Critical years and stages of puberty for spinal and femoral bone mass accumulation during adolescence. J Clin Endocrinol Metab 73: 555–563
Salle BL, Braillon P, Glorieux FH, Brunet J, Cavero E, Meunier PJ 1992 Lumbar bone mineral content measured by dual energy X ray absorptiometry in newborns and infants. Acta Pediatr 81: 953–958
Tsukahara H, Sudo M, Umezaki M, Fujii Y, Kuriyama M, Yamamoto K, Ishii Y 1993 Measurement of lumbar spine bone mineral density in preterm infants by dual energy X ray absorptiometry. Biol Neonate 64: 96–103
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Supported by a University of Tennessee Medical Research Grant and by The University of Tennessee – Memphis Clinical Research Center, USPHS grant RR 00211–29.No reprints available.
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Koo, W., Hockman, E. Physiologic Predictors of Lumbar Spine Bone Mass in Neonates. Pediatr Res 48, 485–489 (2000). https://doi.org/10.1203/00006450-200010000-00011
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DOI: https://doi.org/10.1203/00006450-200010000-00011
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