title: The bone mineral density in childhood study: bone mineral content and density according to age, sex, and race.
abstract: BACKGROUND
  Low bone mass may increase risk of fracture. Several chronic medical conditions, medications, and lifestyle factors affect bone mineral accrual. Appropriate reference values are essential for identification of children with bone deficits.
  
  
  OBJECTIVE
  Our objective was to establish reference curves for bone mineral content (BMC) and density (BMD) in children.
  
  
  METHODS
  The Bone Mineral Density in Childhood Study is an ongoing longitudinal study in which measurements are obtained annually at five clinical centers in the United States.
  
  
  METHODS
  Participants included 1554 healthy children (761 male, 793 female), ages 6-16 yr, of all ethnicities.
  
  
  METHODS
  Scans of the whole body, lumbar spine, hip, and forearm were obtained using dual-energy x-ray absorptiometry. Percentile curves based on three annual measurements were generated using the LMS statistical procedure.
  
  
  RESULTS
  BMC of the whole body and lumbar spine and BMD of the whole body, lumbar spine, total hip, femoral neck, and forearm are given for specific percentiles by sex, age, and race (Black vs. non-Black). BMC and BMD were higher for Blacks at all skeletal sites (P < 0.0001). BMC and BMD increased with age, and a plateau was not evident by age 16 (girls) or age 17 (boys). The variation in BMC and BMD also increased with age.
  
  
  CONCLUSIONS
  Age-, race-, and sex-specific reference curves can be used to help identify children with bone deficits and for monitoring changes in bone in response to chronic diseases or therapies.
authors.affiliation: Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. heidi.kalkwarf@cchmc.org
authors.forename: Heidi J
authors.initials: HJ
authors.lastname: Kalkwarf
authors.forename: Babette S
authors.initials: BS
authors.lastname: Zemel
authors.forename: Vicente
authors.initials: V
authors.lastname: Gilsanz
authors.forename: Joan M
authors.initials: JM
authors.lastname: Lappe
authors.forename: Mary
authors.initials: M
authors.lastname: Horlick
authors.forename: Sharon
authors.initials: S
authors.lastname: Oberfield
authors.forename: Soroosh
authors.initials: S
authors.lastname: Mahboubi
authors.forename: Bo
authors.initials: B
authors.lastname: Fan
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Frederick
authors.forename: Karen
authors.initials: K
authors.lastname: Winer
authors.forename: John A
authors.initials: JA
authors.lastname: Shepherd
mesh_terms: D015502:Absorptiometry, Photon / Q000592:standards* / Q000706:statistics & numerical data*; D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data*; D017677:Age Distribution; D015519:Bone Density; D002648:Child; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D010372:Pediatrics; D012016:Reference Values; D017678:Sex Distribution