title: Skeletal health in Duchenne dystrophy: bone-size and subcranial dual-energy X-ray absorptiometry analyses.
abstract: BACKGROUND
  We performed subcranial and bone-size-adjusted whole body dual-energy X-ray absorptiometry (DXA) to evaluate skeletal health in Duchenne dystrophy (DMD).
  
  
  METHODS
  Total body bone mineral density (TBBMD)-for-age, subcranial, and size-adjusted DXA analyses were performed on 22 DMD patients (5-17 years) and compared with 267 controls from a database. The skull contribution to total body bone mineral content (TBBMC) and corticosteroid effects were also examined.
  
  
  RESULTS
  DMD boys had deficits in TBBMD-for-age (Z = -1.2), which increased with age. The skull's contribution to TBBMC decreased from 45% to 15% with growth. Z-scores for subcranial skeleton were significantly lower than TBBMC-for-area and TBBMD-for-age.
  
  
  CONCLUSIONS
  Size-adjusted and subcranial analyses improve evaluation of whole body DXA. DMD boys have low BMD for size not commensurate with total body areal BMD-for-age. Bone fragility fractures in DMD may result from both decreased BMD and smaller bones. This information is vital to determine appropriate intervention. Muscle Nerve 49:512-519, 2014.
authors.affiliation: Department of Neurology, Wexner Medical Center, The Ohio State University, 395 West 12th Avenue, Columbus, Ohio, 43210, USA.
authors.forename: Wendy M
authors.initials: WM
authors.lastname: King
authors.forename: John T
authors.initials: JT
authors.lastname: Kissel
authors.forename: Diane
authors.initials: D
authors.lastname: Visy
authors.forename: Prem K
authors.initials: PK
authors.lastname: Goel
authors.forename: Velimir
authors.initials: V
authors.lastname: Matkovic
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods* / Q000592:standards; D000293:Adolescent; D000886:Anthropometry / Q000379:methods; D015519:Bone Density / Q000502:physiology*; D002648:Child; D006801:Humans; D008297:Male; D020388:Muscular Dystrophy, Duchenne / Q000000981:diagnostic imaging*; D012886:Skull / Q000000981:diagnostic imaging*; D051598:Whole Body Imaging / Q000379:methods* / Q000592:standards
keywords: Duchenne muscular dystrophy; bone health; bone mineral density; dual-energy X-ray absorptiometry; skeletal development; steroids and bone