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

<div><p>Aims</p><p>To establish normative data for phalangeal quantitative ultrasound (QUS) measures in Brazilian students.</p><p>Methods</p><p>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.</p><p>Results</p><p>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.</p><p>Conclusion</p><p>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.</p></div

Relationship of AD-SoS (left panel) and AD-SoS Z-score (right panel) versus independents variables for total sample and divided by weight categories in boys.

<p>Relationship of AD-SoS (left panel) and AD-SoS Z-score (right panel) versus independents variables for total sample and divided by weight categories in boys.</p

AD-SoS Z-scores according to skin color and weight status.

<p>^a Significant differences from obese, p<0,001</p><p>^b Significant differences from overweight, p<0,001</p><p>^c Significant differences from obese, p<0,05</p><p>^d Significant differences from overweight, p<0,01.</p><p>AD-SoS Z-scores according to skin color and weight status.</p

General characteristics of the sample.

<p>^aDifferences between sexes, p<0.001, Mann-Whitney Test.</p><p>^bWeight status established according to BMI Z-score cut-offs defined by IOTF: Thinness: <-1.01 and <0.98; Normal: between -1.01 to 1.30 and -0.98 to 1.23; Overweigh: between 1.31 to 2.28 and 1.24 to 2.18 and Obese: >2.28 and >2.18 for boys and girls, respectively.</p><p>General characteristics of the sample.</p

Linear (solid line) and cubic (dotted line) relationship between AD-SoS and BMI for girls and boys.

<p>Linear (solid line) and cubic (dotted line) relationship between AD-SoS and BMI for girls and boys.</p

Smoothed percentile charts of AD-SoS for girls according to age (year), height (cm) and weight (kg).

<p>Smoothed percentile charts of AD-SoS for girls according to age (year), height (cm) and weight (kg).</p

Relationship of AD-SoS (left panel) and AD-SoS Z-score (right panel) versus independents variables for total sample and divided by weight categories in girls.

<p>Relationship of AD-SoS (left panel) and AD-SoS Z-score (right panel) versus independents variables for total sample and divided by weight categories in girls.</p