Puberte Dönemindeki Erkeklerde ve Kızlarda Normal Kemik Mineral Yoğunluk Ölçümleri: Kesitsel Bir Dxa Çalışması

Amaç: Ülkemizdeki normal kemik mineral yoğunluğu (KMY) veritabanına katkıda bulunmak için puberte dönemindeki erkeklerde ve kızlarda normal kemik mineral yoğunluk (KMY) ölçümlerini sunmayı amaçladık.Gereç ve Yöntem: Bu çalışmaya puberte döneminde olan, normal KMY değerlerine sahip, Tanner evre 2-5 arasındaki 30 olgu (14 erkek, 16 kız) dahil edildi. Erkek ve kız gruplarının yaş ortalamaları sırasıyla 13.6±1.4 and 13.7±1.6 yıl idi (p>0.05). Lomber (L1-4) ve femur boynu KMY ölçümleri dual enerji X-ışını absorbsiyometri (DXA) ile yapıldı. Erkek ve kızların lomber ve femoral KMY ölçümleri karşılaştırıldı. Her cinsiyet grubu içinde lomber ve femoral KMY değerleri yaş, ağırlık, boy ve vücut kitle indeksi (VKİ) ile korele edildi.Bulgular: Erkek ve kızların ortalama yaşları, ağırlıkları, boyları ve VKİ’leri arasında anlamlı farklılık bulunmadı (P>0.05). Pubertal kızların ortalama lomber KMY değerleri erkeklerinkinden anlamlı olarak daha yüksekti (P<0.05). Kızların grubunda ortalama yaş ile ortalama lomber KMY ölçümleri arasında anlamlı korelasyon mevcuttu (P<0.05). Erkeklerin grubunda ortalama ağırlık ile ortalama KMY ölçümleri (lomber ve femoral) arasında anlamlı korelasyon mevcuttu (P<0.05). Sonuç: Sonuç olarak DXA, pubertal erkek ve kızlarda lomber (L1-4) ve femur boynu KMY ölçümlerinde yararlı, hızlı ve doğruluğu yüksek bir tanısal araçtır.

Anahtar Kelimeler:

Kemik Dansitesi, Femur Boynu, Lumbar Vertebra, Puberte

Normal Bone Mineral Density Measurements in Pubertal Males and Females: A Cross-Sectional DXA Study Abstract

Objective: Our main goal was to present normal BMD measurements in pubertal males and females in order to make contribution to the the database of normative BMD values in our country. Methods: In this study 30 pubertal subjects (14 males, 16 females) with Tanner stage II-V having normal BMD values were enrolled. The mean ages of the male and female groups were 13.6±1.4 and 13.7±1.6 years, respectively (P>0.05). The BMD measurements of lumbar spine (L1-4) and femoral neck were done by dual x-ray absorptiometry (DXA). Lumbar and femoral BMD measurements of male and female subjects were compared. Lumbar and femoral neck BMD values were correlated with the age, weight, height and body mass index of the subjects within each gender groups.Results: There was no significant difference between mean ages, mean weight, mean height and mean BMI of male and females (P>0.05). The mean lumbar BMD value was statistically higher in pubertal females compared to males (P<0.05). There was significant correlation between the mean age and the mean lumbar BMD measurements in female group (P<0.05). There was significant correlation between the mean weight and the mean BMD measurements (lomber and femoral BMD) in male group (P<0.05). Conclusion: In conclusion, DXA is a useful, fast and accurate diagnostic tool for performing BMD measurements of lumbar spine (L1-4) and femoral neck in pubertal males and females.

Keywords:

Bone Density, Femur Neck, Lumbar Vertebrae, Puberty,

PDF

___

1. Heilman K, Zilmer M, Zilmer K, Tillmann V. Lower bone mineral density in children with type 1 diabetes is associated with poor glycemic control and higher serum ICAM-1 and urinary isoprostane levels. J Bone Miner Metab 2009;27(5):598−604. 2. Tuna Kırsaçlıoğlu C, Kuloğlu Z, Tanca A, Küçük NÖ, Aycan Z, Öcal G, et al. Bone mineral density and growth in children with coeliac disease on a gluten free-diet. Turk J Med Sci 2016;46(6):1816−21. 3. Shaw NJ. Management of osteoporosis in children. Eur J Endocrinol 2008;159 Suppl 1:S33−9. 4. Bachrach LK, Gordon CM. Bone densitometry in children and adolescents. Pediatrics 2016;138(4). pii: e20162398. 5. 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. 6. Ponder SW, McCormick DP, Fawcett HD, Palmer JL, McKernan MG, Brouhard BH. Spinal bone mineral density in children aged 5.00 through 11.99 years. Am J Dis Child 1990;144(12):1346−8. 7. Kröger H, Kotaniemi A, Kröger L, Alhava E. Development of bone mass and bone density of the spine and femoral neck-a prospective study of 65 children and adolescents. Bone Miner 1993; 23(3):171−82. 8. Ersoy B, Gökşen D, Darcan S, Mavi E, Oztürk C. Evaluation of bone mineral density in children with diabetes mellitus. Indian J Pediatr 1999;66(3):375−9. 9. Salvatoni A, Mancassola G, Biasoli R, Cardani R, Salvatore S, Broggini M, et al. Bone mineral density in diabetic children and adolescents: a follow-up study. Bone 2004;34(5):900−4. 10. Plaza-Carmona M, Vicente-Rodríguez G, Gómez-Cabello A, Martín-García M, Sánchez-Sánchez J, Gallardo L, et al. Higher bone mass in prepubertal and peripubertal female footballers. Eur J Sport Sci 2016;16(7):877−83. 11. 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. 12. Yilmaz D, Ersoy B, Bilgin E, Gümüşer G, Onur E, Pinar ED. Bone mineral density in girls and boys at different pubertal stages: relation with gonadal steroids, bone formation markers, and growth parameters. J Bone Miner Metab 2005;23(6):476–82. 13. Buran T, Kasap E, Gökçe B, Gümüşer G. Ülseratif kolit hastalığı kemik mineral yoğunluğunu etkiler mi? CBU-SBED: Celal Bayar University-Health Sciences Institute Journal 2018;5(3):145−50. 14. Fountoulis G, Kerenidi T, Kokkinis C, Georgoulias P, Thriskos P, Konstantinos Gourgoulianis, et al. Assessment of bone mineral density in male patients with chronic obstructive pulmonary disease by DXA and quantitative computed tomography. Int J Endocrinol 2016;2016:6169721. doi: 10.1155/2016/6169721. 15. Schnabel M, Eser G, Ziller V, Mann D, Mann E, Hadji P. Bone mineral density in postmenopausal women with proximal femoral fractures--comparative study between quantitative ultrasonometry and gold standard DXA. Zentralbl Chir 2005;130:469−75. 16. Doneray H, Orbak Z. Association between anthropometric hormonal measurements and bone mineral density in puberty and constitutional delay of growth and puberty. West Indian Med J 2010;59(2):125−30. 17. Goksen D, Darcan S, Coker M, Kose T. Bone mineral density of healthy Turkish children and adolescents. J Clin Densitom 2006;9(1):84−90. 18. Hasanoğlu A, Tümer L, Ezgü FS. Vertebra and femur neck bone mineral density values in healthy Turkish children. Turk J Pediatr 2004;46(4):298−302. 19. Bachrach LK. Osteoporosis in children: still a diagnostic challenge. J Clin Endocrinol Metab 2007;92(6):2030–2. 20. Titmuss AT, Biggin A, Korula S, Munns CF. Diagnosis and management of osteoporosis in children. Curr Pediatr Rep 2015;3:187−199. 21. Neyzi O, Günöz H, Furman A, Bundak R, Gökçay G, Darendeliler F, et al. Türk çocuklarında vücut ağırlığı, boy uzunluğu, baş çevresi ve vücut kitle indeksi referans değerleri. Çocuk Sağlığı ve Hastalıkları Derg 2008;51:1−14. 22. Tanner JM. Growth and adolescence. Physical growth and development. In: textbook of Paediatrics, 2nd ed, Blackwell Scientific, Oxford, 1962. 23. Looker AC, Borrud LG, Hughes JP, Fan B, Shepherd JA, Melton LJ 3rd. Lumbar spine and proximal femur bone mineral density, bone mineral content, and bone area: United States, 2005–2008. National Center for Health Statistics. Vital Health Stat 2012;11(251):1−132. 24. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 2000; 894: i-xii, 1−253. 25. Bozan G, Doğruel N. Obez prepubertal ve pubertal çocuklarda serum leptin ve kemik mineral dansitometresi ilişkisinin incelenmesi. Osmangazi Tıp Derg 2017;39(3):27−34. 26. Bachrach LK, Gordon CM. Bone densitometry in children and adolescents. Pediatrics 2016;138(4). pii: e20162398.