Universität zu Köln

Bianchi, Maria Luisa ORCID: 0000-0002-9261-0732, Leonard, Mary B., Bechtold, Susanne, Hoegler, Wolfgang ORCID: 0000-0003-4328-6304, Mughal, M. Zulf, Schoenau, Eckhart, Sylvester, Francisco A., Vogiatzi, Maria, van den Heuvel-Eibrink, Marry M. and Ward, Leanne (2014). Bone Health in Children and Adolescents With Chronic Diseases That May Affect the Skeleton: The 2013 ISCD Pediatric Official Positions. J. Clin. Densitom., 17 (2). S. 281 - 295. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1559-0747

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Abstract

The aim of this Task Force was to review the use of dual-energy X-ray absorptiometry (DXA) in children and adolescents with underlying chronic diseases that pose risk factors for compromised bone health, such as inflammation, glucocorticoid therapy, or decreased mobility. The Task Force systematically analyzed more than 270 studies, with an emphasis on those published in the interval since the original 2007 Position Statements. Important developments over this period included prospective cohort studies demonstrating that DXA measures of areal bone mineral density (aBMD) predicted incident fractures and the development of robust reference data and strategies to adjust for bone size in children with growth impairment. In this report, we summarize the current literature on the relationship between DXA-based aBMD and both fracture (vertebral and non-vertebral) outcomes and non-fracture risk factors (e.g., disease characteristics, ambulatory status, and glucocorticoid exposure) in children with chronic illnesses. Most publications described the aBMD profile of children with underlying diseases, as well as the cross-sectional or longitudinal relationship between aBMD and clinically relevant non-fracture outcomes. Studies that addressed the relationship between aBMD and prevalent or incident fractures in children with chronic illnesses are now emerging. In view of these updated data, this report provides guidelines for the use of DXA-based aBMD in this setting. The initial recommendation that DXA is part of a comprehensive skeletal healthy assessment in patients with increased risk of fracture is unchanged. Although the prior guidelines recommended DXA assessment in children with chronic diseases at the time of clinical presentation with ongoing monitoring, this revised Position Statement focuses on the performance of DXA when the patient may benefit from interventions to decrease their elevated risk of a clinically significant fracture and when the DXA results will influence that management.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Bianchi, Maria Luisa UNSPECIFIED orcid.org/0000-0002-9261-0732 UNSPECIFIED Leonard, Mary B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Bechtold, Susanne UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoegler, Wolfgang UNSPECIFIED orcid.org/0000-0003-4328-6304 UNSPECIFIED Mughal, M. Zulf UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoenau, Eckhart UNSPECIFIED UNSPECIFIED UNSPECIFIED Sylvester, Francisco A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Vogiatzi, Maria UNSPECIFIED UNSPECIFIED UNSPECIFIED van den Heuvel-Eibrink, Marry M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Ward, Leanne UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-441201
DOI:	10.1016/j.jocd.2014.01.005
Journal or Publication Title:	J. Clin. Densitom.
Volume:	17
Number:	2
Page Range:	S. 281 - 295
Date:	2014
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1559-0747
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACUTE LYMPHOBLASTIC-LEUKEMIA; IDIOPATHIC JUVENILE OSTEOPOROSIS; INFLAMMATORY-BOWEL-DISEASE; GROWTH-HORMONE DEFICIENCY; LONG-TERM SURVIVORS; MINERAL DENSITY; CYSTIC-FIBROSIS; TURNER SYNDROME; FRACTURE RISK; ANOREXIA-NERVOSA Multiple languages Endocrinology & Metabolism Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/44120