Top

Indian Journal of Pediatrics

Published in:

09-11-2022 | Dexamethasone | Original Article

Assessment of Bone Health Using Dual-Energy X-Ray Absorptiometry (DEXA) And Its Association with Dietary Intakes, Serum Vitamin D Levels, and Anthropometric Measures in Healthy Urban Preschool Children

Authors: Sumithra Selvam, Srinivasan K.

Published in: Indian Journal of Pediatrics | Issue 12/2023

Abstract

Objectives

To generate reference data for bone mineral content (BMC) and bone mineral density (BMD) measures among apparently healthy children aged 4–5 y and to study the relationship of BMC and BMD with age, sex, anthropometric measures, dietary intakes, and serum vitamin D levels.

Methods

This cross-sectional study was conducted among 219 urban preschool children, aged 4.0–5.11 y. Bone health (BMC and BMD) was measured using dual energy X-ray absorptiometry (DEXA). Anthropometric parameters were measured using standard methodology. The 24-h dietary recall method was used to assess the dietary intake of the children. Serum vitamin D levels were assessed using the ELISA kit method. Percentiles for BMC and BMD for each age and sex were constructed using the lambda-mu-sigma (LMS) method.

Results

The mean BMD and BMC among children was 0.75 ± 0.04 g/cm² and 544.9 ± 87.6 g, respectively, and were significantly different by age and sex category. The BMC and BMD values of boys and girls increased with age, with boys having significantly higher values. A significant positive correlation was observed for BMC and BMD with anthropometric measures and dietary intake of calcium, phosphorous, protein, zinc, and B vitamins.

Conclusion

This study developed smoothed percentile curves for BMC and BMD in preschool children, which could be used as reference values for children from India.

Mithal A, Bansal B, Kyer CS, Ebeling P. The Asia-pacific regional audit-epidemiology, costs, and burden of osteoporosis in India 2013: a report of international osteoporosis foundation. Indian J Endocrinol Metab. 2014;18:449–54.CrossRefPubMedPubMedCentral

Office of the Surgeon General (US). Bone Health and Osteoporosis: A Report of the Surgeon General. Rockville (MD): Office of the Surgeon General (US); 2004.

Khoshhal KI. Childhood osteoporosis. J Taibah Univ Med Sci. 2011;2:61–76.

Davies JH, Evans BA, Gregory JW. Bone mass acquisition in healthy children. Arch Dis Child. 2005;90:373–8.CrossRefPubMedPubMedCentral

Golden NH, Abrams SA; Committee on Nutrition. Optimizing bone health in children and adolescents. Pediatrics. 2014;134:e1229–43.

Crabtree NJ, Arabi A, Bachrach LK, et al; International Society for Clinical Densitometry. Dual-energy x-ray absorptiometry interpretation and reporting in children and adolescents: the revised 2013 ISCD Pediatric Official Positions. J Clin Densitom. 2014:17:225–42

Sopher AB, Fennoy I, Oberfield SE. An update on childhood bone health: mineral accrual, assessment and treatment. Curr Opin Endocrinol Diabetes Obes. 2015;22:35–40.CrossRefPubMedPubMedCentral

Godang K, Qvigstad E, Voldner N, et al. Assessing body composition in healthy newborn infants: reliability of dual-energy x-ray absorptiometry. J Clin Densitom. 2010;13:151–60.CrossRefPubMed

Manousaki D, Rauch F, Chabot G, Dubois J, Fiscaletti M, Alos N. Pediatric data for dual x-ray absorptiometric measures of normal lumbar bone mineral density in children under 5 years of age using the lunar prodigy densitometer. J Musculoskelet Neuronal Interact. 2016;16:247–55.PubMedPubMedCentral

10.

Khadilkar AV, Sanwalka NJ, Chiplonkar SA, Khadilkar VV, Mughal MZ. Normative data and percentile curves for dual energy x-ray absorptiometry in healthy Indian girls and boys aged 5–17 years. Bone. 2011;48:810–9.CrossRefPubMed

11.

Levine MA. Assessing bone health in children and adolescents. Indian J Endocr Metab. 2012;16(Suppl 2):S205–12.CrossRef

12.

McVey MK, Geraghty AA, O’Brien EC, et al. The impact of diet, body composition, and physical activity on child bone mineral density at five years of age-findings from the ROLO Kids Study. Eur J Pediatr. 2020;179:121–31.CrossRefPubMed

13.

Palacios C. The role of nutrients in bone health, from A to Z. Crit Rev Food Sci Nutr. 2006;46:621–8.CrossRefPubMed

14.

Cole T.J. The LMS method for constructing normalized growth standards. Eur J Clin Nutr. 1990;44:45–60.

15.

Indian Academy of Pediatrics Growth Charts Committee, Khadilkar V, Yadav S, Agrawal KK, et al. Revised IAP growth charts for height, weight and body mass index for 5- to 18-year-old Indian children. Indian Pediatr. 2015;52:47–55.

16.

Heymsfield SB, Lichtman S, Baumgartner RN, et al. Body composition of humans: comparison of two improved four-compartment models that differ in expense, technical complexity and radiation exposure. Am J Clin Nutr. 1990;52:52–8.CrossRefPubMed

17.

Munns CF, Shaw N, Kiely M, et al. Global Consensus Recommendations on prevention and management of nutritional rickets. J Clin Endocrinol Metab. 2016;101:394–415.CrossRefPubMedPubMedCentral

18.

Bharathi AV, Kurpad AV, Thomas T, Yusuf S, Saraswathi G, Vaz M. Development of food frequency questionnaires and a nutrient database for the Prospective Urban and Rural Epidemiological (PURE) pilot study in south India: methodological issues. Asia Pac J Clin Nutr. 2008;17:178–85.

19.

Cole T.J. Fitting smoothed centile curves to reference data. Journal of the Royal Statistical Society, 1988;151,385–418.

20.

Nakavachara P, Pooliam J, Weerakulwattana L, et al. A normal reference of bone mineral density (BMD) measured by dual energy X-ray absorptiometry in healthy thai children and adolescents aged 5-18 years: a new reference for Southeast Asian populations. PLoS One. 2014;9:e97218.

21.

Lifshitz F, Hecht JP, Bermúdez EF, et al. Body composition analysis by dual-energy X-ray absorptiometry in young preschool children. Eur J Clin Nutr. 2016;70:1203–9.

22.

Ali GY, Abdelbary EE, Albuali WH, AboelFetoh NM, AlGohary EH. Bone mineral density & bone mineral content in Saudi children, risk factors and early detection of their affection using dual-emission X-ray absorptiometry (DEXA) scan. Egyptian Pediatric Association Gazette. 2017;65:65–71.

23.

Tubić B, Magnusson P, Swolin-Eide D, Mårild S; IDEFICS Consortium. Relation between bone mineral density, biological markers and anthropometric measures in 4-year-old children: a pilot study within the IDEFICS study. Int J Obes (Lond). 2011;35Suppl 1:S119–24.

24.

Joo NS, Dawson-Hughes B, Yeum KJ. 25-Hydroxyvitamin D, calcium intake, and bone mineral content in adolescents and young adults: analysis of the fourth and fifth Korea National Health and Nutrition Examination Survey (KNHANES IV-2, 3, 2008–2009 and V-1, 2010). J Clin Endocrinol Metab. 2013;98:3627–36.

25.

Pan K, Zhang C, Yao X, Zhu Z. Association between dietary calcium intake and BMD in children and adolescents. Endocr Connect. 2020;9:194–200.

26.

Juzwiak CR, Amancio OM, Vitalle MS, Szejnfeld VL, Pinheiro MM. Effect of calcium intake, tennis playing, and body composition on bone-mineral density of Brazilian male adolescents. Int J Sport Nutr Exerc Metab. 2008;18:524–38.

27.

Ekbote VH, Khadilkar AV, Chiplonkar SA, Khadilkar VV. Determinants of bone mineral content and bone area in Indian preschool children. J Bone Miner Metab. 2011;29:334–41.

28.

Lee AW, Cho SS. Association between phosphorus intake and bone health in the NHANES population. Nutr J. 2015;14:28.

29.

Bounds W, Skinner J, Carruth BR, Ziegler P. The relationship of dietary and lifestyle factors to bone mineral indexes in children. J Am Diet Assoc. 2005;105:735–41.

30.

Fratoni V, Brandi ML. B vitamins, homocysteine and bone health. Nutrients. 2015;7:2176–92.

31.

Palermo A, Tuccinardi D, Defeudis G, et al. BMI and BMD: The potential interplay between obesity and bone fragility. Int J Environ Res Public Health. 2016;13:544.

Title: Assessment of Bone Health Using Dual-Energy X-Ray Absorptiometry (DEXA) And Its Association with Dietary Intakes, Serum Vitamin D Levels, and Anthropometric Measures in Healthy Urban Preschool Children
Authors: Sumithra Selvam
Srinivasan K.
Publication date: 09-11-2022
Publisher: Springer India
Keyword: Dexamethasone
Published in: Indian Journal of Pediatrics / Issue 12/2023
Print ISSN: 0019-5456
Electronic ISSN: 0973-7693
DOI: https://doi.org/10.1007/s12098-022-04364-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Assessment of Bone Health Using Dual-Energy X-Ray Absorptiometry (DEXA) And Its Association with Dietary Intakes, Serum Vitamin D Levels, and Anthropometric Measures in Healthy Urban Preschool Children

Abstract

Objectives

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objectives

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 12/2023

Serum Calprotectin in Juvenile Idiopathic Arthritis: A Hope or Hype?

Exome Sequencing in Monogenic Forms of Rickets

Crescentic IgA Nephropathy Following Varicella Infection in a 7-y-old-Boy: Hitherto Unreported Association

The Incidence of CMV Infection and Disease in Pediatric Allogenic Stem Cell Transplant Recipients

Is Herpes Simplex Encephalitis Different in Infants and Toddlers?

Essential Pediatric Pulmonology: Sushil K Kabra and Rakesh Lodha (eds)