PROBLEMS OF BONE MINERAL DENSITY IN THE PEDIATRIC POPULATION OF ADJARA REGION
DOI:
https://doi.org/10.52340/jecm.2024.05.20Keywords:
Bone Mineral Density, Osteoporosis, Z scoreAbstract
Background: Despite having a low mortality rate, pediatric low bone density has a significant morbidity burden. During pubertal peak growth velocity, approximately 25% of peak bone mass is accumulated. If this peak is not optimal, it will manifest the development of osteoporosis in adulthood. Thirty percent of pediatric population suffers fractures. One of the main risk factors is low bone mass.
Objectives: During clinical practice, attention was paid to the fact that osteopenia was observed in the pediatric population. We decided to investigate the bone density index using ultrasound densitometry in children of Adjara Region. Also, up to date statistical data was not found in reliable scientific sources, which fueled our desire to be more interested in the prevalence of low bone density in pediatric population.
Methods: Research was conducted at JSC “Seamen’s Medical Centre – 2010“ Batumi, Adjara, Georgia between 2020 to 2023 by utilizing an Ultrasound Bone Densitometer Sonost 2000.
Results: Among the 155 evaluated participants included in this study were aged less than 18 years, 52.90% (n=82) were girls, and 47,10% (n=73) were boys. Among them, 94.83% (n=147) demonstrated a bone density index below Normal (Low, Deficient, Critical), and 67% (n=98) of them had a deficiency in the daily consumption of dairy products.
Conclusion: According to our research, 94.83% (n=147) of children in Adjara region had a low bone density index. Notably, girls exhibited a more pronounced reduction in bone density. These results highlight the significance of monitoring and promoting the ideal bone mass in children and adolescents, also the necessity of early interventions to reduce the chance of osteoporosis in later life. There is a probable association with the reduced consumption of dairy products.
Downloads
References
Y. Uziel, E. Zifman, P. J. Hashkes, “Osteoporosis in children: Pediatric and pediatric rheumatology perspective: A review,” Pediatric Rheumatology, 2009 Oct 16; 7:16. doi: 10.1186/1546-0096-7-16.
C. M. Laine and T. Laine, “Diagnosis of osteoporosis in children and adolescents,” Eur Endocrinol, vol. 9, no. 2, pp. 141–144, 2013, doi: 10.17925/ee.2013.09.02.141.
K. I. Khoshhal and F. Ed, “Childhood Osteoporosis.”
L. M. Ward, D. R. Weber, C. F. Munns, W. Högler, and B. S. Zemel, “A contemporary view of the definition and diagnosis of osteoporosis in children and adolescents,” Journal of Clinical Endocrinology and Metabolism, vol. 105, no. 5. Endocrine Society, May 01, 2020. doi: 10.1210/clinem/dgz294.
A. T. Titmuss, A. Biggin, S. Korula, and C. F. Munns, “Diagnosis and Management of Osteoporosis in Children,” Curr Pediatr Rep, vol. 3, no. 2, pp. 187–199, Jun. 2015, doi: 10.1007/s40124-015-0082-z.
A. D. G. Baxter-Jones, R. A. Faulkner, M. R. Forwood, R. L. Mirwald, and D. A. Bailey, “Bone mineral accrual from 8 to 30 years of age: An estimation of peak bone mass,” Journal of Bone and Mineral Research, vol. 26, no. 8, pp. 1729–1739, Aug. 2011, doi: 10.1002/jbmr.412.
K. Gipson, M. Lu, and T. B. Kinane, “Sleep-disordered breathing in children,” Pediatr Rev, vol. 40, no. 1, pp. 3–12, Jan. 2019, doi: 10.1542/pir.2018-0142.
G. Saggese, G. I. Baroncelli, S. Bertelloni, and G. I. Baroncelli Endocrine, “Osteoporosis in Children and Adolescents: Diagnosis, Risk Factors, and Prevention,” 2001.
F. Rauch et al., “Fracture Prediction and the Definition of Osteoporosis in Children and Adolescents: The ISCD 2007 Pediatric Official Positions,” Journal of Clinical Densitometry, vol. 11, no. 1, pp. 22–28, Jan. 2008, doi: 10.1016/j.jocd.2007.12.003.
M. B. Leonard, “Glucocorticoid-induced osteoporosis in children: Impact of the underlying disease,” in Pediatrics, Mar. 2007. doi: 10.1542/peds.2006-2023J.
I. L. Engvall, B. Svensson, B. Tengstrand, K. Brismar, and I. Hafström, “Impact of low-dose prednisolone on bone synthesis and resorption in early rheumatoid arthritis: Experiences from a two-year randomized study,” Arthritis Res Ther, vol. 10, no. 6, Nov. 2008, doi: 10.1186/ar2542.
J. Bacchetta, K. Wesseling-Perry, et al. “Idiopathic juvenile osteoporosis: a cross-sectional single-centre experience with bone histomorphometry and quantitative computed tomography,” 2013. [Online]. Available: http://www.ped-rheum.com/content/11/1/6
S. Docio et al. Seasonal Deficiency of Vitamin D in Children: A Potential Target for Osteoporosis-Preventing Strategies? 1998.
S. A. Bowden, R. F. Robinson, R. Carr, and J. D. Mahan, “Prevalence of vitamin D deficiency and insufficiency in children with osteopenia or osteoporosis referred to a pediatric metabolic bone clinic,” Pediatrics, vol. 121, no. 6, Jun. 2008, doi: 10.1542/peds.2007-2111.
N. S. Sies et al., “Obstructive sleep apnoea syndrome (OSAS) as a risk factor for secondary osteoporosis in children,” Sci Rep, vol. 11, no.1, Dec. 2021, doi: 10.1038/s41598-021-82605-6.
H. Hartikka et al., “Heterozygous mutations in the LDL receptor-related protein 5 (LRP5) gene are associated with primary osteoporosis in children,” Journal of Bone and Mineral Research, vol. 20, no. 5, pp. 783–789, May 2005, doi: 10.1359/JBMR.050101.
S. Ciancia et al., “Osteoporosis in children and adolescents: when to suspect and how to diagnose it,” European Journal of Pediatrics, vol. 181, no. 7. Springer Science and Business Media Deutschland GmbH, pp. 2549–2561, Jul. 01, 2022. doi: 10.1007/s00431-022-04455-2.
Galindo-Zavala R, Bou-Torrent R, Magallares-López B, Mir-Perelló C, Palmou-Fontana N, Sevilla-Pérez B, Medrano-San Ildefonso M, González-Fernández MI, Román-Pascual A, Alcañiz-Rodríguez P, Nieto-Gonzalez JC, López-Corbeto M, Graña-Gil J. Expert panel consensus recommendations for diagnosis and treatment of secondary osteoporosis in children. Pediatr Rheumatol Online J. 2020 Feb 24;18(1):20. doi: 10.1186/s12969-020-0411-9. PMID: 32093703; PMCID: PMC7041118.
M. P. Jeremiah, B. K. Unwin, and M. H. Greenawald, “Diagnosis and Management of Osteoporosis,” 2015. [Online]. Available: www.aafp.org/afp
A. M. Boyce and R. I. Gafni, “Approach to the child with fractures,” Journal of Clinical Endocrinology and Metabolism, vol. 96, no. 7, pp. 1943–1952, Jul. 2011, doi: 10.1210/jc.2010-2546.
K. H. Chong, B. K. Poh, N. A. Jamil, N. A. Kamaruddin, and P. Deurenberg, “Radial quantitative ultrasound and dual energy X-ray absorptiometry: Intermethod agreement for bone status assessment in children,” Biomed Res Int, vol. 2015, 2015, doi: 10.1155/2015/232876.
L. K. Bachrach, “Osteoporosis in children: Still a diagnostic challenge,” Journal of Clinical Endocrinology and Metabolism, vol. 92, no. 6. Endocrine Society, pp. 2030–2032, 2007. doi: 10.1210/jc.2007-0828.
J. Kocks, K. Ward, Z. Mughal, R. Moncayo, J. Adams, and W. Högler, “Z-score comparability of bone mineral density reference databases for children,” Journal of Clinical Endocrinology and Metabolism, vol. 95, no. 10, pp. 4652–4659, 2010, doi: 10.1210/jc.2010-0677.
R. I. Gafni and J. Baron, “Overdiagnosis of osteoporosis in children due to misinterpretation of Dual-energy x-ray absorptiometry (DEXA),” Journal of Pediatrics, vol. 144, no. 2, pp. 253–257, Feb. 2004, doi: 10.1016/j.jpeds.2003.08.054.
F. F. Alqahtani and A. C. Offiah, “Diagnosis of osteoporotic vertebral fractures in children,” Pediatric Radiology, vol. 49, no.3. Springer Verlag, pp 283–296, Mar 07, 2019. doi: 10.1007/s00247-018-4279-5.
A. J. Sawyer et al., “Chapter 2 / Measuring Bone in Children and Adolescents 15 15 2 From: Current Clinical Practice: Bone Densitometry in Growing Patients: Guidelines for Clinical Practice c c Edited Tools for Measuring Bone in Children and Adolescents.”
E. Adiotomre et al., “Diagnostic accuracy of DXA compared to conventional spine radiographs for the detection of vertebral fractures in children,” EurRadiol, vol. 27, no. 5, pp. 2188–2199, May 2017, doi: 10.1007/s00330-016-4556-3.
P. Adamczyk, M. Szczepanska, and W. Pluskiewicz, “Skeletal status assessment by quantitative ultrasound and bone densitometry in children with different renal conditions,” Osteoporosis International, vol. 29, no. 12, pp. 2667–2675, Dec. 2018, doi: 10.1007/s00198-018-4659-6.
R. R. van Rijn et al., “Bone densitometry in children: A critical appraisal,” European Radiology, vol. 13, no. 4. Springer Verlag, pp. 700–710, Apr. 01, 2003. doi: 10.1007/s00330-002-1676-8.
Rosengren BE, Bergman E, Karlsson J, Ahlborg H, Jehpsson L, Karlsson MK. Downturn in Childhood Bone Mass: A Cross-Sectional Study Over Four Decades. JBMR Plus. 2021 Nov 26;6(1):e10564. doi: 10.1002/jbm4.10564. PMID: 35079676; PMCID: PMC8770995.
Downloads
Published
How to Cite
Issue
Section
