title: Revised reference curves for bone mineral content and areal bone mineral density according to age and sex for black and non-black children: results of the bone mineral density in childhood study.
abstract: BACKGROUND
  Deficits in bone acquisition during growth may increase fracture risk. Assessment of bone health during childhood requires appropriate reference values relative to age, sex, and population ancestry to identify bone deficits.
  
  
  OBJECTIVE
  The objective of this study was to provide revised and extended reference curves for bone mineral content (BMC) and areal bone mineral density (aBMD) in children.
  
  
  METHODS
  The Bone Mineral Density in Childhood Study was a multicenter longitudinal study with annual assessments for up to 7 yr.
  
  
  METHODS
  The study was conducted at five clinical centers in the United States.
  
  
  METHODS
  Two thousand fourteen healthy children (992 males, 22% African-Americans) aged 5-23 yr participated in the study.
  
  
  METHODS
  There were no interventions.
  
  
  METHODS
  Reference percentiles for BMC and aBMD of the total body, lumbar spine, hip, and forearm were obtained using dual-energy x-ray absorptiometry for Black and non-Black children. Adjustment factors for height status were also calculated.
  
  
  RESULTS
  Extended reference curves for BMC and aBMD of the total body, total body less head, lumbar spine, total hip, femoral neck, and forearm for ages 5-20 yr were constructed relative to sex and age for Black and non-Black children. Curves are similar to those previously published for 7-17 year olds. BMC and aBMD values were greater for Black vs. non-Black children at all measurement sites.
  
  
  CONCLUSIONS
  We provide here dual-energy x-ray absorptiometry reference data on a well-characterized cohort of 2012 children and adolescents. These reference curves provide the most robust reference values for the assessment and monitoring of bone health in children and adolescents in the literature to date.
authors.affiliation: Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. zemel@email.chop.edu
authors.forename: Babette S
authors.initials: BS
authors.lastname: Zemel
authors.forename: Heidi J
authors.initials: HJ
authors.lastname: Kalkwarf
authors.forename: Vicente
authors.initials: V
authors.lastname: Gilsanz
authors.forename: Joan M
authors.initials: JM
authors.lastname: Lappe
authors.forename: Sharon
authors.initials: S
authors.lastname: Oberfield
authors.forename: John A
authors.initials: JA
authors.lastname: Shepherd
authors.forename: Margaret M
authors.initials: MM
authors.lastname: Frederick
authors.forename: Xiangke
authors.initials: X
authors.lastname: Huang
authors.forename: Ming
authors.initials: M
authors.lastname: Lu
authors.forename: Soroosh
authors.initials: S
authors.lastname: Mahboubi
authors.forename: Thomas
authors.initials: T
authors.lastname: Hangartner
authors.forename: Karen K
authors.initials: KK
authors.lastname: Winer
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000367:Age Factors; D000375:Aging / Q000378:metabolism*; D000465:Algorithms; D044383:Black People; D015519:Bone Density / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D005272:Femur Neck / Q000033:anatomy & histology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011627:Puberty / Q000502:physiology; D012016:Reference Values; D012737:Sex Factors; D014481:United States / Q000453:epidemiology; D044465:White People; D055815:Young Adult; D001741:Black or African American