ICCBH2013 Oral Communications Epidemiology (6 abstracts)
The Amalgamated Paediatric Bone Density Study (The ALPHABET Study): the collation and generation of UK based reference data for paediatric bone densitometry
Nicola Crabtree 1 , Mike Machin 2 , Natalie Bebbington 1 , Judith Adams 2 , Faisal Ahmed 3 , Paul Arundel 4 , Nicholas Bishop 4 , Mary Fewtrell 5 , Wolgang Hogler 1 , M Zulf Mughal 6 , Laura Rhodes 7 , Nicholas Shaw 1 & Kate Ward 8
1Birmingham Children’s Hospital, Birmingham, UK; 2Central Manchester University Hospital’s NHS Foundation Trust, Manchester, UK; 3Royal Hospital for Sick Children, Glasgow, UK; 4Sheffield Children’s Hospital, Sheffield, UK; 5Institute for Child Health, London, UK; 6Royal Manchester Children’s Hospital, Manchester, UK; 7University of Leeds, Leeds, UK; 8MRC Human Nutrition Research Elsie Widdowson Laboratory, Cambridge, UK.
Understanding normal patterns of bone growth is important for optimising bone health in children and reducing osteoporotic fractures in later life. Recently published guidelines for bone assessment in children state that to predict fractures a technique should identify children at risk of clinically significant fractures and that dual-energy absorptiometry (DXA) is the preferred method of assessment. Despite these guidelines there is still inconsistency and lack of consensus regarding the management of paediatric bone disease across centres, both nationally and internationally. The major inconsistencies arise from lack of robust reference data and clarity regarding the diagnostic application of these data. The aim of this project was to create a large robust but modifiable reference data set for the assessment of bone status in children by collating all currently available UK measurements of bone density in healthy children.
Seven centres provided data on just over 3000 healthy children aged between 5 and 20 years. DXA scans were acquired from either GE Lunar (DPX-L, Prodigy and iDXA) or Hologic Discovery. To account for the known differences between Hologic and GE scanners and between different generations of machines in vivo and in vitro cross calibration was performed. To ensure consistency all scans were analysed using the latest version of software (Apex 4.0; Hologic, Encore 14.0 GE). To test for significant historic changes in software versions and ensure sustainability of the reference data for future software iterations a subset of 100 Hologic and 100 GE scans were randomly selected from the database.
Analysis between software versions was stable for lumbar spine and hip scans. However, significant changes were recorded for the latest versions of whole body analysis. Standardisation of the data was achieved using transformation equations generated from the in-vivo cross calibration and published data (Shepherd 2011). Overall, 3030 whole body, 2823 lumbar spine and 1221 hip scans were included in the dataset from which gender, age and size specific reference curves were generated.
In summary, the newly generated curves provide robust reference data which enables successful interpretation of paediatric DXA scans and permits clinicians to follow internationally agreed guidelines on the interpretation of paediatric DXA.
Declaration of funding
This work was funded by an Arthritis Research-UK Grant.
K Ward is funded by Medical Research Council Grant Code U105960371.
Volume 2
Article tools
My recent searches
My recently viewed abstracts
Authors
Bone Abstracts
ISSN 2052-1219 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more