Spine bone densitometry in asthmatic children treated with high dose corticosteroids: correcting for racial discrepancies.
OBJECTIVE
Our hypothesis is that the use of standards based on Caucasian children will under-estimate the incidence of abnormal bone density in African American children.


METHODS
Eighty-two African American and 80 Caucasian asthmatic children classified as high-dose inhaled corticosteroid users comprised the study population. Bone mineral density measurements were compared to reference standards, based on Caucasians, to calculate Z-values. Regression analysis was used to compare Z-values derived from the race-specific and Caucasian standards for 32 African American children. The derived regression analysis equation was then applied to the entire African American population to determine the incidence of abnormal bone density.


RESULTS
The asthmatic Caucasian mean spine bone density was significantly less than the normal standards (p < .001), but the African American mean spine bone density was not, despite the high-dose steroid use. Using the Caucasian standards, Caucasians were significantly more likely to have abnormal bone density detected (p < 0.015). Regression analysis of the 32 children with available race specific standards resulted in the following equation: Z African American= Z Caucasian-0.86. The number of African Americans with abnormal bone density detected using the regression equation was not significantly different than the Caucasian children (p > 0.12).


CONCLUSIONS
Asthmatic African Americans treated with high-dose inhaled corticosteroids had denser bones than Caucasians. Caucasian standards can be adjusted using a regression equation.
Greenberg
S Bruce
SB
Arkansas Children's Hospital and University of Arkansas for Medical Sciences, USA.
Simpson
Pippa M
PM
Jones
Stacie M
SM
Holloway
Sharla
S
Seibert
Joanna J
JJ
D015502:Absorptiometry, Photon; D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy* / Q000208:ethnology / Q000503:physiopathology; D015519:Bone Density / Q000187:drug effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D010024:Osteoporosis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000208:ethnology*; D012015:Reference Standards; D013131:Spine / Q000000981:diagnostic imaging / Q000187:drug effects*; D044465:White People / Q000706:statistics & numerical data
D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents