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Trabecular bone score (TBS) and bone mineral density (BMD) analysis by dual X‐ray absorptiometry (DXA) in healthy Brazilian children and adolescents: normative data

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Abstract

Summary

Childhood and adolescence are crucial periods for healthy bone development throughout life. This study aims to establish normative data for trabecular bone score (TBS) and bone mineral density (BMD) measurements using dual-energy X-ray absorptiometry (DXA) in healthy Brazilian children and adolescents.

Purpose

To establish normative data for trabecular bone score (TBS) and bone mineral density (BMD) measurements using dual energy X-ray absorptiometry (DXA) in healthy Brazilian children and adolescents.

Methods

Healthy children and adolescents, aged 5 to 19 years, underwent medical interview, physical examination with anthropometric measurement, pubertal stage evaluation, and bone densitometry by DXA (Hologic QDR 4500). Boys and girls were divided into 2 age groups: 5–9 years old (children) and 10–19 years old (adolescents). BMD and bone mineral content (BMC) were measured following standard procedures. TBS measurements were performed using the TBS Insight ® v3.0.3.0 software.

Results

A total of 349 volunteers were enrolled in this cross-sectional study. Reference values were defined for each group of children and adolescents divided into 3-year age groups. Girls had lower values of TBS compared to boys (1.356 ± 0.116 and 1.380 ± 0.086 respectively, p = 0.029). For both boys and girls, BMC and spine BMD measurements were significantly higher in adolescent than in children (p = 0.0001; p = 0.0001; p = 0.0001, p = 0.0001, respectively). TBS range increased as pubertal development progressed. In both girls and boys, a 1-year increase in age was associated to a 0.013 increase in TBS. Body mass was a significant determinant for TBS. In girls, a 1 kg/m2 increase in BMI was associated to an average TBS increase of 0.008.

Conclusion

Our findings reinforce the evidence that TBS varies according to age, sex, and pubertal stage in healthy children and adolescents. This study established reference values for TBS in healthy Brazilian children and adolescents which can be used as normative data for this population.

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Funding

This work was supported by the Remaining Funds of the Brazilian Society of Rheumatology.

Author information

Authors and Affiliations

  1. Paediatric Rheumatology Unit, Paediatrics Department, Universidade Federal de São Paulo, São Paulo, Brazil

    Melissa Mariti Fraga & Maria Teresa Terreri

  2. Graduate Student at Medical School, Universidade Federal de São Paulo, São Paulo, Brazil

    Filipe Pedroso de Sousa

  3. Division of Rheumatology, Department of Medicine, Federal University of São Paulo, São Paulo, Brazil

    Vera Lucia Szejnfeld, Charlles Heldan de Moura Castro & Marcelo de Medeiros Pinheiro

Authors
  1. Melissa Mariti Fraga
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  2. Filipe Pedroso de Sousa
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Correspondence to Melissa Mariti Fraga.

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Learning objectives

On completion of this article, you should be able to:

1. Have gathered normative data of trabecular bone score to compare with other children and adolescents.

2. Have gathered normative data of bone mineral density to compare with other children and adolescents.

3. Understand that Trabecular bone score (TBS) and bone mineral density (BMD) can vary according to sex, age, and pubertal stage.

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Fraga, M.M., de Sousa, F.P., Szejnfeld, V.L. et al. Trabecular bone score (TBS) and bone mineral density (BMD) analysis by dual X‐ray absorptiometry (DXA) in healthy Brazilian children and adolescents: normative data. Arch Osteoporos 18, 82 (2023). https://doi.org/10.1007/s11657-023-01291-1

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