Lumbar spine and proximal femur BMD values in Turkish girls and the effect of precocious puberty on BMD

Lumbar spine and proximal femur BMD values in Turkish girls and the effect of precocious puberty on BMD

Previous studies have shown no impairment in bone mineral density in girls with precocious and early puberty. The aim of this study was to evaluate the effect of precocious puberty on BMD and to measure average bone mineral density in Turkish girls. Fourteen girls between the ages of 5-10 (7.57 ± 1.83 year) who had new diagnosed precocious and early puberty were included in this study. BMD was measured in the posterior-anterior projection at the lumbar spine and at the right hip using DEXA. Correlation analysis was performed among BMD in all sub-regions. According to age, new average BMD values of sub-regionals in lumbar spine and proximal femur were calculated by linear regression formula leading to an average value of the lumbar spine total BMD in normal population. According to new average ± SD BMD of all sub-regions, simulated new Z-scores of each girl in proximal femur and lumbar spine were calculated and statistically compared. We found significant Z-score correlation between proximal femur and lumbar spine (r=0.70 " 0.99). According to age, new average values of sub-regional BMD in lumbar vertebrae and proximal femoral sub-regions in Turkish girls were presented. Average spinal BMD values in Turkish girls were similar with western countries. We though that DEXA scan at lumbar spine, with the exception of some patients, may be enough for an accurate measurement in children.

___

  • Pasquino AM, Pucarelli I, Accardo F, Demiraj V, Segni M, Di Nardo R. Long-term observation of 87 girls with idiopathic central precocious puberty treated with gonadotropin-releasing hormone analogs: impact on adult height, body mass index, bone mineral content, and reproductive function. J Clin Endocrinol Metab. 2008;93(1):190-5.
  • Unal O, Berberoğlu M, Evliyaoğlu O, Adiyaman P, Aycan Z, Ocal G. Effects on bone mineral density of gonadotropin releasing hormone analogs used in the treatment of central precocious puberty. J Pediatr Endocrinol Metab. 2003;16(3):407-11.
  • Kapteijns-van Kordelaar S, Noordam K, Otten B, van den Bergh J. Quantitative calcaneal ultrasound parameters and bone mineral density at final height in girls treated with depot gonadotrophin-releasing hormone agonist for central precocious puberty or idiopathic short stature. Eur J Pediatr. 2003;162(11):776-80.
  • Ko JH, Lee HS, Lim JS, Kim SM, Hwang JS. Changes in bone mineral density and body composition in children with central precocious puberty and early puberty before and after one year of treatment with GnRH agonist. Horm Res Paediatr. 2011;75(3):174-9.
  • Magiakou MA, Manousaki D, Papadaki M, Hadjidakis D, Levidou G, Vakaki M, Papaefstathiou A, Lalioti N, Kanaka-Gantenbein C, Piaditis G, Chrousos GP, Dacou- Voutetakis C. The efficacy and safety of gonadotropin-releasing hormone analog treatment in childhood and adolescence: a single center, long-term follow-up study. J Clin Endocrinol Metab. 2010;95(1):109-17.
  • Wacharasindhu S, Petwijit T, Aroonparkmongkol S, Srivuthana S, Kingpetch K. Bone mineral density and body composition in Thai Precocious Puberty girls treated with GnRH agonist. J Med Assoc Thai. 2006;89(8):1194-8.
  • Gafni RI, Baron J. Overdiagnosis of osteoporosis in children due to misinterpretation of dual-energy x-ray absorptiometry (DEXA). J Pediatr. 2004;144(2):253-7.
  • Arikoski P, Komulainen J, Voutilainen R, Kröger L, Kröger H. Lumbar bone mineral density in normal subjects aged 3-6 years: a prospective study. Acta Paediatr. 2002;91(3):287-91.
  • Henderson RC. The correlation between dual-energy X-ray absorptiometry measures of bone density in the proximal femur and lumbar spine of children. Skeletal Radiol. 1997;26(9):544-7.
  • Bachrach LK. Dual energy X-ray absorptiometry (DEXA) measurements of bone density and body composition: promise and pitfalls. J Pediatr Endocrinol Metab. 2000;13 Suppl 2:983-8.
  • Fonseca AS, Szejnfeld VL, Terreri MT, Goldenberg J, Ferraz MB, Hilário MO. Bone mineral density of the lumbar spine of Brazilian children and adolescents aged 6 to 14 years. Braz J Med Biol Res. 2001;34(3):347-52.
  • Assa A, Weiss M, Aharoni D, Mor A, Rachmiel M, Bistritzer T. Evaluation of bone density in girls with precocious and early puberty during treatment with GnRH agonist. J Pediatr Endocrinol Metab. 2011;24(7-8):505-10.