Bone mineral density and Trabecular Bone Score in children and adolescents

Background. Decreased bone mineral density (BMD) and bone tissue (BT) quality are often the causes of osteoporosis, which is common not only in adults but also in children. Today, the main strategy for preventing the occurrence of osteoporosis is to achieve the highest bone mass (BM) in childhood and adolescence. The main strategy in preventing the occurrence of osteoporosis is to achieve the highest bone mass (BM) in childhood and adolescence. Identifying the most significant factors contributing to the accumulation of BM can prevent fractures not only in the elderly but also in adolescence, when the developing skeleton is extremely vulnerable. The purpose of the research work was to study the BMD indicators and BT quality in schoolchildren and determine their relationship with age, gender, sexual development, physical activity and the le­vel of vitamin D supply. Materials and methods. One hundred and forty-two pupils of Kyiv secondary schools aged 8–17 years were examined. All children underwent anthropometric measurements, and the stage of sexual development according to Tanner was determined. Dual-energy X-ray densitometry was used to assess BMD and BT quality. Low BM for this chronological age was indicated by BMD levels < –2 SD according to the z-criterion. Trabecular BT quality was assessed using the Trabecular Bone Score. Vitamin D deficiency was detected when the level of 25(OH)D in blood serum was below 20 ng/ml, its insufficiency — 21–30 ng/ml, and the optimal level — 31–50 ng/ml. Statistical processing of the obtained data was carried out by generally accepted methods of medical statistics using Microsoft Excel 365 and Statistics (IBM Corp, USA). Results. 6.3 % of schoolchildren had low BM indicators. In children and adolescents with insufficient weight and low physical activity, statistically significantly lower BMD were detected. A statistically significant deficiency of vitamin D was determined in children with low BMD, and with normal BMD, the average level of 25(OH)D was within the limits of its insufficiency. It was found that BMD increases during puberty. Conclusions. Age and level of sexual maturity likely influence BMD and the Trabecular Bone Score. Adequate physical activity, optimal vitamin D status, and maintaining a normal body weight can contribute to higher BMD and overall skeletal health improvement.