Race-neutral Pediatric Reference Ranges for Bone Mineral Density Predict Prospective Fractures in Childhood
Authors' conclusion
We present the first race-neutral pediatric reference ranges for BMD and BMAD that are weighted to be representative of the US population and demonstrate that these Z-scores associate with fracture risk. Adoption of these new reference ranges should be considered, with thoughtful implementation for patients previously monitored with race-specific reference ranges, especially among children who identify as Black.
Study context
- Population
- Children in the Bone Mineral Density in Childhood Study with longitudinal DXA bone mineral density (BMD) of spine, hip, forearm and total body less head
- Comparison
- Race-neutral vs race-specific BMD and BMAD Z-scores
Methodological detailslongitudinal
- Longitudinal
Primary result
As reported in the abstract
Race-neutral BMD and BMAD Z-scores greater than race-specific Z-scores for Black children
0.5 to 0.7 SD
Race-neutral Z-scores lower than race-specific for children from other race/ethnicity groups
∼0.1 SD
Reduced fracture risk per 1 SD increase in race-neutral Z-scores
12% to 18%
Further findings
Modifiers of group differences
- Growth and lifestyle factors modified group differences
Original publication
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