Pediatric pQCT-derived tibial bone mineral density estimates: A systematic review and meta-regression

IF 3.9 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Bone Pub Date : 2026-02-01 Epub Date: 2025-11-08 DOI:10.1016/j.bone.2025.117720

Anna Maria Markarian , Dennis R. Taaffe , Daniel A. Galvão , Jodie Cochrane Wilkie , Carolyn J. Peddle-McIntyre , Mark Markarian , Daniel J. Schiferl , Robert U. Newton

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引用次数: 0

Abstract

Background

Assessing bone mineral density (BMD) in children and adolescents is essential for detecting skeletal deficits and fracture risk. Peripheral quantitative computed tomography (pQCT) has gained increasing attention as a valuable imaging tool due to its ability to assess bone quality. Unlike dual-energy x-ray absorptiometry, pQCT provides volumetric BMD measurements and distinguishes between cortical and trabecular compartments. Despite these advantages, its clinical adoption remains limited due to the lack of reference data and standardized protocols.

Methods

A systematic search was conducted in CINAHL, Embase, PubMed, SPORTDiscus, and Web of Science from inception to November 2024. Studies reporting pQCT-derived tibial BMD in healthy children and adolescents (<19 years old) were included. Meta-regression models using natural cubic splines were applied to estimate age-specific BMD values for trabecular and cortical bone. Potential moderators, such as sex, race, reference line location, limb, and pQCT device, were evaluated to assess their influence on BMD outcomes.

Results

Eighty-three studies (18,531 participants) were included in this review. The meta-regression models demonstrated a non-linear relationship between BMD and age, best described using natural cubic splines. Moderator analysis indicated that sex, race, and reference line location significantly influenced cortical BMD, while trabecular BMD was affected by reference line location and pQCT device. The choice of limb assessed (dominant vs non-dominant) had minimal impact on BMD outcomes.

Conclusion

We present pQCT-derived BMD estimates from a diverse cohort of healthy children and adolescents and identify key moderators. Our findings provide a foundation for improved understanding and future standardization, laying the groundwork for enhancing the clinical utility of pQCT.

查看原文本刊更多论文

儿童pqct衍生胫骨骨密度估计：系统回顾和meta回归。

背景：评估儿童和青少年的骨密度（BMD）对于发现骨骼缺陷和骨折风险至关重要。外周定量计算机断层扫描（pQCT）作为一种有价值的成像工具，由于其评估骨质量的能力而受到越来越多的关注。与双能x线吸收仪不同，pQCT提供了体积骨密度测量，并区分了皮质和小梁间室。尽管有这些优势，但由于缺乏参考数据和标准化方案，其临床应用仍然有限。方法：系统检索CINAHL、Embase、PubMed、SPORTDiscus、Web of Science自建站至2024年11月。报告pqct衍生的健康儿童和青少年胫骨骨密度的研究(结果：83项研究（18,531名受试者）纳入本综述。meta回归模型显示BMD与年龄之间存在非线性关系，最好使用自然三次样条来描述。调节分析表明，性别、种族和参考线位置显著影响皮质骨密度，而参考线位置和pQCT设备影响小梁骨密度。评估肢体的选择（优势与非优势）对骨密度结果的影响最小。结论：我们从不同的健康儿童和青少年队列中提出了pqct衍生的BMD估计值，并确定了关键的调节因素。我们的研究结果为进一步了解和规范pQCT奠定了基础，为提高pQCT的临床应用奠定了基础。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bone 医学-内分泌学与代谢

CiteScore

8.90

自引率

4.90%

发文量

264

审稿时长

30 days

期刊介绍： BONE is an interdisciplinary forum for the rapid publication of original articles and reviews on basic, translational, and clinical aspects of bone and mineral metabolism. The Journal also encourages submissions related to interactions of bone with other organ systems, including cartilage, endocrine, muscle, fat, neural, vascular, gastrointestinal, hematopoietic, and immune systems. Particular attention is placed on the application of experimental studies to clinical practice.