Evaluation of bone mineralization in former preterm born children: Phalangeal quantitative ultrasound cannot replace dual-energy X-ray absorptiometry
Background: Preterm infants are at risk of impaired bone health in later life. Dual-energy X-ray absorptiometry-scan (DXA) is the gold standard to determine bone mineralization. Phalangeal quantitative ultrasound (pQUS) is an alternative technique that is inexpensive, easy to use and radiation-free....
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-06-01
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| Series: | Bone Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352187218300044 |
| _version_ | 1828911519360876544 |
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| author | Carmen M.T. Lageweg Mayke E. van der Putten Johannes B. van Goudoever Ton Feuth Martin Gotthardt Arno F.J. van Heijst Viola Christmann |
| author_facet | Carmen M.T. Lageweg Mayke E. van der Putten Johannes B. van Goudoever Ton Feuth Martin Gotthardt Arno F.J. van Heijst Viola Christmann |
| author_sort | Carmen M.T. Lageweg |
| collection | DOAJ |
| description | Background: Preterm infants are at risk of impaired bone health in later life. Dual-energy X-ray absorptiometry-scan (DXA) is the gold standard to determine bone mineralization. Phalangeal quantitative ultrasound (pQUS) is an alternative technique that is inexpensive, easy to use and radiation-free. The aim of this study was to investigate whether both techniques reveal equivalent results. Materials and methods: Sixty former preterm infants (31 boys; 29 girls) received a DXA and pQUS at age 9 to 10 years. DXA measured bone mineral content (BMC) and bone mineral density (BMD) for total body and lumbar spine (L1-4), while pQUS measured the amplitude dependent speed of sound (AD-SoS) and bone transit time (BTT) at metacarpals II-IV providing continuous values and Z-scores based on age and sex. Four statistical methods evaluated the association between both techniques: Pearson's correlation coefficients, partial correlation coefficients adjusted for gestational age, height and BMI, Bland-Altman analysis and cross tabulation. Results: Both techniques showed a statistically significant weak correlation for continuous values as well as Z-scores (0.291–0.462, p < 0.05). Boys had significant and relatively high correlations (0.468–0.585, p < 0.05). In comparison, the correlations for girls were not significant. Correlation coefficients further decreased while calculating the partial correlations. The Bland-Altman plots showed poor agreement. Sensitivity ranged from 33% to 92% and specificity from 16% to 68%. Positive and negative predictive values ranged from 4% to 38% and 82% to 97%, respectively. Conclusions: We found statistically significant weak correlations and poor agreement between DXA and pQUS measurements. DXA is not equivalent to pQUS and therefore not replaceable by this technique in former preterm born children at the age of 9 to 10 years. Keywords: Bone development, Children, Correlation, Dual-energy X-ray absorptiometry-scan, Speed of sound, Ultrasound |
| first_indexed | 2024-12-13T19:04:21Z |
| format | Article |
| id | doaj.art-9e77918c75624fc8a522ddcee5d0b57a |
| institution | Directory Open Access Journal |
| issn | 2352-1872 |
| language | English |
| last_indexed | 2024-12-13T19:04:21Z |
| publishDate | 2018-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Bone Reports |
| spelling | doaj.art-9e77918c75624fc8a522ddcee5d0b57a2022-12-21T23:34:36ZengElsevierBone Reports2352-18722018-06-0183845Evaluation of bone mineralization in former preterm born children: Phalangeal quantitative ultrasound cannot replace dual-energy X-ray absorptiometryCarmen M.T. Lageweg0Mayke E. van der Putten1Johannes B. van Goudoever2Ton Feuth3Martin Gotthardt4Arno F.J. van Heijst5Viola Christmann6Department of Pediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The NetherlandsDepartment of Pediatrics, Subdivision of Neonatology, Maastricht University Medical Center, Maastricht, The NetherlandsDepartment of Pediatrics, VU University Medical Center Amsterdam, Amsterdam, The Netherlands; Departement of Pediatrics, Emma Children's Hospital – AMC Amsterdam, Amsterdam, The NetherlandsDepartment for Health Evidence, Radboud Institute for Health Science, Subdivision of Biostatistics, Radboud university medical center, Nijmegen, The NetherlandsDepartment of Radiology and Nuclear Medicine, Radboud university medical center, Nijmegen, The NetherlandsDepartment of Pediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The NetherlandsDepartment of Pediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, Nijmegen, The Netherlands; Corresponding author at: Department of Pediatrics, Subdivision of Neonatology, Radboudumc Amalia Children's Hospital, Radboud University Medical Center, P.O. Box 9101, Internal Postal Code 804, 6500 HB Nijmegen, The Netherlands.Background: Preterm infants are at risk of impaired bone health in later life. Dual-energy X-ray absorptiometry-scan (DXA) is the gold standard to determine bone mineralization. Phalangeal quantitative ultrasound (pQUS) is an alternative technique that is inexpensive, easy to use and radiation-free. The aim of this study was to investigate whether both techniques reveal equivalent results. Materials and methods: Sixty former preterm infants (31 boys; 29 girls) received a DXA and pQUS at age 9 to 10 years. DXA measured bone mineral content (BMC) and bone mineral density (BMD) for total body and lumbar spine (L1-4), while pQUS measured the amplitude dependent speed of sound (AD-SoS) and bone transit time (BTT) at metacarpals II-IV providing continuous values and Z-scores based on age and sex. Four statistical methods evaluated the association between both techniques: Pearson's correlation coefficients, partial correlation coefficients adjusted for gestational age, height and BMI, Bland-Altman analysis and cross tabulation. Results: Both techniques showed a statistically significant weak correlation for continuous values as well as Z-scores (0.291–0.462, p < 0.05). Boys had significant and relatively high correlations (0.468–0.585, p < 0.05). In comparison, the correlations for girls were not significant. Correlation coefficients further decreased while calculating the partial correlations. The Bland-Altman plots showed poor agreement. Sensitivity ranged from 33% to 92% and specificity from 16% to 68%. Positive and negative predictive values ranged from 4% to 38% and 82% to 97%, respectively. Conclusions: We found statistically significant weak correlations and poor agreement between DXA and pQUS measurements. DXA is not equivalent to pQUS and therefore not replaceable by this technique in former preterm born children at the age of 9 to 10 years. Keywords: Bone development, Children, Correlation, Dual-energy X-ray absorptiometry-scan, Speed of sound, Ultrasoundhttp://www.sciencedirect.com/science/article/pii/S2352187218300044 |
| spellingShingle | Carmen M.T. Lageweg Mayke E. van der Putten Johannes B. van Goudoever Ton Feuth Martin Gotthardt Arno F.J. van Heijst Viola Christmann Evaluation of bone mineralization in former preterm born children: Phalangeal quantitative ultrasound cannot replace dual-energy X-ray absorptiometry Bone Reports |
| title | Evaluation of bone mineralization in former preterm born children: Phalangeal quantitative ultrasound cannot replace dual-energy X-ray absorptiometry |
| title_full | Evaluation of bone mineralization in former preterm born children: Phalangeal quantitative ultrasound cannot replace dual-energy X-ray absorptiometry |
| title_fullStr | Evaluation of bone mineralization in former preterm born children: Phalangeal quantitative ultrasound cannot replace dual-energy X-ray absorptiometry |
| title_full_unstemmed | Evaluation of bone mineralization in former preterm born children: Phalangeal quantitative ultrasound cannot replace dual-energy X-ray absorptiometry |
| title_short | Evaluation of bone mineralization in former preterm born children: Phalangeal quantitative ultrasound cannot replace dual-energy X-ray absorptiometry |
| title_sort | evaluation of bone mineralization in former preterm born children phalangeal quantitative ultrasound cannot replace dual energy x ray absorptiometry |
| url | http://www.sciencedirect.com/science/article/pii/S2352187218300044 |
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