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dc.creatorMartins, A-
dc.creatorMonjardino, T-
dc.creatorCanhão, H-
dc.creatorLucas, R-
dc.identifier.issn0803-5253 -
dc.description.abstractAim: Peripheral methods are increasingly used to assess bone health, despite little evidence on their predictive ability. We aimed to evaluate the usefulness of forearm dual‐energy X‐ray absorptiometry in prepubertal children, by estimating the agreement between peripheral and central measures and the ability to predict fracture history. Methods: In 2012/2014, we assessed 1177 seven‐year‐old children from the Generation XXI cohort who were recruited at birth in all five public hospitals with maternity wards in Porto, Portugal. Subtotal and lumbar spine bone mineral density (BMD) and content, left‐arm BMD and peripheral forearm BMD were measured. Parents reported the child's lifetime fracture history. We estimated agreement using Bland–Altman's method and Cohen's kappa. Fracture prediction ability was calculated using area under the receiver operator characteristic curve (ROC‐AUC). Results: The limits of agreement were very wide, ranging from −2.20/2.20 to −1.87/1.87 standard deviations for the comparison between peripheral and central measures. Categorical agreement was also poor, with all kappa values below 0.40. In addition, none of the measures predicted fractures, because all the ROC‐AUCs were close to 0.50. Conclusion: This study suggests that forearm BMD has limited use for bone health research or as a basis for clinical decisions in prepubertal children.pt_PT
dc.description.sponsorshipGeneration XXI was funded by FEDER through the Operational Programme Competitiveness and Internationalization and by national funds through the FCT – Fundação para a Ciência e a Tecnologia via grants POCI-01-0145-FEDER-016838 and POCI-01-0145-FEDER-016837, under the projects PTDC/DTP-EPI/1687/2014 and PTDC/DTP-EPI/3306/2014. Support by Administração Regional de Saúde Norte (Ministry of Health), Fundação Calouste Gulbenkian and Unidade de Investigação em Epidemiologia – Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (POCI-01-0145-FEDER-006862; UID/DTP/04750/2013) is also acknowledged. TM and RL were supported by grants BD/92370/2013 and BPD/88729/2012 and co-funded by FCT and the POPH/FSE Programme and AM by the MSD merit scholarship to the Masters in Public Health of Universidade do Porto.pt_PT
dc.publisherJohn Wiley & Sons Ltd.pt_PT
dc.relation.ispartofseriesActa Paediatr, vol. 106(8), p. 1336-1340pt_PT
dc.subjectBone mineral densitypt_PT
dc.subjectPeripheral densitometrypt_PT
dc.titleCohort study shows that peripheral dual energy x-ray absorptiometry is of limited epidemiologic use in prepubertal childrenpt_PT
dc.typeArtigo em Revista Científica Internacionalpt_PT
dc.contributor.uportoInstituto de Saúde Públicapt_PT
Appears in Collections:ISPUP - Artigo em Revista Científica Internacional

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