title: Axial quantitative ultrasound assessment of pediatric bone quality in eastern Nepal.
abstract: This study presents quantitative ultrasonography (QUS) bone quality data for an underrepresented, south Asian pediatric population from Nepal. Data were collected as part of a longitudinal study of growth and development. This study offers normative data and documents the effect of stunting, wasting, and underweight on the bone properties measured by QUS.
  
  
  BACKGROUND
  The purpose of this study was to (1) examine the bone quality of a rural, non-Western pediatric population using QUS, (2) explore variation in the trajectory of bone quality development between males and females, and (3) examine the impact of growth disruption(s) on bone quality.
  
  
  METHODS
  A cross-sectional study of 860 children and adolescents aged 5-18 years from the Jirel ethnic group in eastern Nepal was performed. The Sunlight Omnisense 7000P was used to assess bone quality of the distal 1/3 radius and midshaft tibia. WHO reference standards were used to assess growth disruptions of height, weight, and BMI.
  
  
  RESULTS
  QUS bone quality data for an underrepresented, non-Western pediatric population are presented for the radius and tibia. A sizable portion of the study participants were classified as stunted, wasted, and/or underweight. Despite this prevalence of growth disruption in the study sample, bone quality data conform to other documented populations with less growth disruption. Thus, this study offers normative data and documents the minimal effect of stunting, wasting, and underweight on the bone properties measured by QUS.
  
  
  CONCLUSIONS
  Non-Western pediatric populations are significantly underserved with regard to simple, non-invasive screening tools that may help identify developmental disorders and assess bone health. The children and adolescents examined here represent normal growth and development for an underrepresented south Asian population. While this work demonstrates that stunting, wasting, or underweight status at time of QUS assessment is not associated with poor bone quality, we do suggest that further study is needed to examine possible cumulative effects of persistent disruptions that may lead to compromised bone quality in later adolescence.
authors: Department of Anthropology, Temple University, 1115 Polett Walk, 210 Gladfelter Hall, Philadelphia, PA, 19120, USA, kimberwilliams@temple.edu.
authors: K D
authors: KD
authors: Williams
authors: J
authors: J
authors: Blangero
authors: M C
authors: MC
authors: Mahaney
authors: J
authors: J
authors: Subedi
authors: B
authors: B
authors: Jha
authors: S
authors: S
authors: Williams-Blangero
authors: B
authors: B
authors: Towne
mesh_terms: D000293:Adolescent; D000375:Aging / Q000502:physiology*; D000886:Anthropometry / Q000379:methods; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D001846:Bone Development / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006130:Growth Disorders / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009390:Nepal / Q000453:epidemiology; D011884:Radius / Q000000981:diagnostic imaging / Q000502:physiology; D012016:Reference Values; D012727:Sex Characteristics; D013977:Tibia / Q000000981:diagnostic imaging / Q000502:physiology; D014463:Ultrasonography