title: Reference values for bone mineral density in 12- to 18-year-old girls categorized by weight, race, and age.
abstract: BACKGROUND
  Normative bone mineral density (BMD) values for adults do not apply to the pediatric population because of dramatic and variable rates of bone mineral acquisition that take place throughout adolescence.
  
  
  OBJECTIVE
  This study was designed to provide normative BMD values for the lumbar spine and femoral neck by age, weight, and race in female adolescents for use by clinicians.
  
  
  METHODS
  The study population comprised 422 healthy adolescent girls aged 12-18 years recruited from four primary-care clinics. BMD measurements were performed with dual-energy X-ray absorptiometry (DEXA).
  
  
  RESULTS
  The major statistical predictors of lumbar spine BMD and femoral neck BMD were race, chronological age, and weight. There was an increase in both lumbar spine and femoral neck BMD that paralleled an increase in age and weight. In addition, the lumbar spine BMD and the femoral neck BMD were higher in the black participants than in the non-black participants with mean BMD values in grams per centimeter squared of 1.02 and 0.98, respectively, for blacks and 0.96 and 0.89, respectively, for non-blacks ( P<0.001).
  
  
  CONCLUSIONS
  Our study produced the largest set of lumbar spine and femoral neck BMD normative values for female adolescents and confirms the importance of both demographic and anthropomorphic variables in determining normative BMD values.
authors.affiliation: Department of Pediatrics, MetroHealth Medical Center, Case Western Reserve University School of Medicine, 2500 MetroHealth Dr., Cleveland, OH 44109, USA. bcromer@metrohealth.org
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Cromer
authors.forename: Larry
authors.initials: L
authors.lastname: Binkovitz
authors.forename: Julie
authors.initials: J
authors.lastname: Ziegler
authors.forename: Ray
authors.initials: R
authors.lastname: Harvey
authors.forename: Sara M
authors.initials: SM
authors.lastname: Debanne
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000367:Age Factors; D001835:Body Weight; D015519:Bone Density; D002648:Child; D005260:Female; D005272:Femur Neck; D006801:Humans; D008159:Lumbar Vertebrae; D044469:Racial Groups; D012016:Reference Values; D012737:Sex Factors