Original contribution
Quantitative ultrasound in the assessment of skeletal status in children and adolescents

https://doi.org/10.1016/j.ultrasmedbio.2003.10.023Get rights and content

Abstract

The aim of this study was to provide normative data for quantitative ultrasound (US) through the phalanges and to evaluate the influence of age and body size on Ad-SoS (amplitude-dependent speed-of-sound). Measurements were performed in 1020 healthy Polish children ages 7 to 19 years, using a DBM Sonic 1200 (IGEA, Carpi, Italy). The Ad-SoS increased with age in all studied subjects; in girls from 1926 to 2124 m/s and in boys from 1916 to 2114 m/s. The statistically significant increases in Ad-SoS values were noted between the ages of 10 and 16 years in girls and 13 and 18 years in boys. Correlations and regressions between Ad-SoS and age and body were dependent on the phases of growth. In stepwise multiple linear regression of Ad-SoS on age and body size, the following equations were obtained: in girls, Ad-SoS (m/s) = 1843 + 18 × age (years) + 2.3 × weight (kg) − 9.4 × body mass index (BMI) (kg/m2), r = 0.85, standard error of estimate (SEE) = 42; and, in boys, Ad-SoS (m/s) = 2443 + 14 × age (years) − 3.7 × height (cm) + 8.4 × weight (kg) − 24.8 × BMI (kg/m2), r = 0.83, SEE = 45. In conclusion, the study showed the ability of US measurements at hand phalanges to monitor the skeletal maturation during childhood and adolescence. (E-mail: [email protected])

Introduction

Skeletal development begins in utero and continues at least through the first two decades of life. The amount of skeletal mass acquired during adolescence is one of the most important determinants for the risk of osteoporosis. Childhood and adolescence are crucial periods for the formation of a skeleton (Bonjour et al., 1991, Theintz et al., 1992). Many factors have an influence on peak bone mass. The main determinants of peak bone mass are genetic factors, hormonal status, calcium intake and physical activity (Slemenda et al., 1991, Boot et al., 1997, Lehtonen-Veromaa et al., 2000). The ability to modify some of these factors may influence bone mass positively and prevent osteoporosis in the elderly. Osteoporosis prevention requires a better knowledge of bone mass acquisition. For this reason, assessment of children's skeletal maturity provides important information. Currently, the most used and accepted technique for measuring bone status is dual energy x-ray absorptiometry (DXA), but other methods, such as quantitative computed tomography (QCT) and quantitative ultrasound (US or QUS), are also used. QUS systems exist for measurements at various skeletal sites, such as calcaneus, phalanges, tibia and patella. QUS (in addition to quantitative assessment of bone mass) evaluates bone tissue in regard to qualitative features such as elasticity and bone structure (Glüer et al., 1994, Murgia et al., 1996, Hans et al., 1999). Advantages of this method are simplicity of performing scans, a lack of ionizing radiation and relatively low cost. Such features are especially important in studies performed in children.

In the current study, we assessed a group of 1020 subjects for collecting reference values of US parameters measured in a healthy young Polish population and we evaluated the influence of age and body size on the US parameters.

Section snippets

Materials

The study was performed on 1020 healthy children and adolescents (508 girls and 512 boys) from 7 to 19 years old. The participants were recruited from primary and secondary schools in Zabrze and Gliwice (towns in Silesian conurbation, 60% of all persons), in Białystok (town in Eastern agricultural part of Poland, 20%) and in Brenna (a mountain village, 20%). These diverse sources resulted in a group of subjects representative of the young, healthy Polish population. The characteristics of the

Results

The Ad-SoS increased with age in all studied subjects. In girls, mean values ranged from 1926 m/s to 2224 m/s. Up to age of 10 years, the mean increase of Ad-SoS value was 7.7 m/s per year and the mean values were not significantly different between subgroups. Between subgroups ages 10 to 16 years, the mean increase of Ad-SoS value per year was 27.2 m/s and the mean values were significantly different in comparison with the directly older subgroup (except for between 12- and 13-year-old girls).

Discussion

Several recent studies suggest that phalanges may be an appropriate measurement site because of their sensitivity to detect changes in bone status (Jergas et al., 1995, Takada et al., 1995, Murgia et al., 1996, Ventura et al., 1996, Duboeuf et al., 1996, Pluskiewicz and Drozdzowska, 1998). The current study has provided normative data for QUS through the hand phalanges for Polish healthy young subjects aged 7 to 19 years old. Peak bone mass assessed by DXA appears to be achieved around the age

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