Tathyane Krahenbühl

Brazilian Pediatric Reference Data for Quantitative Ultrasound of Phalanges According to Gender, Age, Height and Weight

Aims To establish normative data for phalangeal quantitative ultrasound (QUS) measures in Brazilian students. Methods The sample was composed of 6870 students (3688 females and 3182 males), aged 6 to 17 years. The bone status parameter, Amplitude Dependent Speed of Sound (AD-SoS) was assessed by QUS of the phalanges using DBM Sonic BP (IGEA, Carpi, Italy) equipment. Skin color was obtained by self-evaluation. The LMS method was used to derive smoothed percentiles reference charts for AD-SoS according to sex, age, height and weight and to generate the L, M, and S parameters. Results Girls showed higher AD-SoS values than boys in the age groups 7–16 (p<0.001). There were no differences on AD-SoS Z-scores according to skin color. In both sexes, the obese group showed lower values of AD-SoS Z-scores compared with subjects classified as thin or normal weight. Age (r2 = 0.48) and height (r2 = 0.35) were independent predictors of AD-SoS in females and males, respectively. Conclusion AD-SoS values in Brazilian children and adolescents were influenced by sex, age and weight status, but not by skin color. Our normative data could be used for monitoring AD-SoS in children or adolescents aged 6–17 years.

Fatores que influenciam a massa óssea de crianças e adolescentes saudáveis mensurada pelo ultrassom quantitativo de falanges: revisão sistemática

Objective: To analyze the main factors that influence bone mass in children and teenagers assessed by quantitative ultrasound (QUS) of the phalanges. Data source: A systematic literature review was performed according to the PRISMA method with searches in databases Pubmed/Medline, SciELO and Bireme for the period 2001-2012, in English and Portuguese languages, using the keywords: children, teenagers, adolescent, ultrasound finger phalanges, quantitative ultrasound of phalanges, phalangeal quantitative ultrasound. Data synthesis: 21 articles were included. Girls had, in QUS, Amplitude Dependent Speed of Sound (AD-SoS) values higher than boys during pubertal development. The values of the parameters of QUS of the phalanges and dual-energy X-ray Absorptiometry (DXA) increased with the increase of the maturational stage. Anthropometric variables such as age, weight, height, body mass index (BMI), lean mass showed positive correlations with the values of QUS of the phalanges. Physical activity has also been shown to be positively associated with increased bone mass. Factors such as ethnicity, genetics, caloric intake and socioeconomic profile have not yet shown a conclusive relationship and need a larger number of studies. Conclusions: QUS of the phalanges is a method used to evaluate the progressive acquisition of bone mass during growth and maturation of individuals in school phase, by monitoring changes that occur with increasing age and pubertal stage. There were mainly positive influences variables of sex, maturity, height, weight and BMI, with similar data when compared to the gold standard method, the DXA.Objetivo:Analisar quais os principais fatores que influenciam na massa ossea de criancas e adolescentes avaliada pelo ultrassom quantitativo (QUS) de falanges.Fonte de dados:Foi realizada revisao sistematica da literatura, de acordo com o metodo Prisma, com buscas nas bases de dados do Pubmed/Medline, Bireme e Scielo, referente ao periodo de 2001 a 2012, nos idiomas ingles e portugues, utilizando os descritores children, adolescent, ultrassonography finger phalanges, quantitative ultrasound of phalanges, phalangeal quantitative ultrasound.Sintese dos dados:Foram incluidos 21 artigos. As meninas apresentaram no QUS valores de Amplitude Dependent Speed of Sound (AD-SoS) superiores aos meninos durante o desenvolvimento puberal. Os valores dos parâmetros do QUS de falanges aumentaram com o incremento do estadio maturacional, assim como ocorre com o Dual-energy X-ray Absorptiometry (DXA). Variaveis antropometricas, como idade, peso, estatura, indice de massa corporal (IMC) e massa magra, demonstraram correlacoes positivas com os valores do QUS de falanges. A atividade fisica tambem demonstrou estar positivamente relacionada ao aumento da massa ossea. Fatores como etnia, genetica, ingestao calorica e perfil socioeconomico ainda nao mostraram relacao conclusiva e necessitam um numero maior de estudos.Conclusoes:O QUS de falanges e um metodo indicado para avaliar a progressiva aquisicao da massa ossea durante o crescimento e a maturacao dos individuos em fase escolar, por acompanhar as alteracoes que ocorrem com o aumento da idade e do estadio puberal. Observouse influencia positiva, principalmente das variaveis de sexo, maturacao, estatura, peso e IMC, sendo seus dados semelhantes quando comparados ao metodo padrao-ouro, o DXA.

Competitive Swimming and Handball Participation Have a Positive Influence on Bone Parameters as Assessed by Phalangeal Quantitative Ultrasound in Female Adolescents

PURPOSE To examine the influence of participation in competitive sports on bone parameters, as assessed by quantitative ultrasound (QUS) of the phalanges in female adolescents. METHODS Female adolescents (n = 329, 13.0-16.7 years old) were classified into handball (n = 55), swimming (n = 49) and control (n = 225) groups. QUS was used to evaluate the amplitude-dependent speed of sound (AD-SoS) and bone transmission time (BTT), and their z-scores (zAD-SoS and zBTT) were calculated. Anthropometric measurements and Tanners stages were also obtained. RESULTS Swimmers had higher AD-SoS (2089 ± 43.8 m/s) and zAD-SoS (0.47 ± 0.8) than controls (2060 ± 54.0 m/s; 0.09 ± 1.0; both p ≤ .05) and both groups of athletes had higher BTT (handball: 1.44 ± 0.2 μs; swimming: 1.45 ± 0.2) and zBTT (handball: 0.71 ± 0.8; swimming: 0.72 ± 1.1) than the control group (1.37 ± 0.2 μs; 0.32 ± 0.9; all p ≤ .05). Swimmers had a higher total training time (TTT: 52.5 ± 27.6 months) and frequency of training per week (FT: 5.38 ± 0.1) compared with the handball group (35.9 ± 18.1; 3.32 ± 0.8; p ≤ .05). zAD-SoS, BTT and zBTT were positively correlated with FT, while BTT and zBTT showed a positive correlation with TTT. CONCLUSIONS Sports practice influences bone parameters and higher bone parameter values are related to the amount of time and frequency of weekly training. The differences in phalangeal QUS parameters are independent of the impact of weight-bearing exercise.

Review ArticleFactors that influence bone mass of healthy children and adolescents measured by quantitative ultrasound at the hand phalanges: a systematic review* Fatores que influenciam a massa óssea de crianças e adolescentes saudáveis mensurada pelo ultrassom quantitativo de falanges: revisão sistemática

Objective To analyze the main factors that influence bone mass in children and teenagers assessed by quantitative ultrasound (QUS) of the phalanges.