Pediatric reference charts of dual-energy X-ray absorptiometry body composition measures.

A population-based cohort of 6102 singleton-born children in Rotterdam provided DXA data for constructing pediatric reference charts across ages 5-20 years.

• The study used a population-based cohort design including children with DXA data from one or more visits between 5 and 20 years.
• 60.5% of participants had DXA data at 3 or more time-points.
• Measures included TBLH-BMD, TBLH-BMC, FM%, FMI, LST%, LMI, and ALMI.
• Reference charts were calculated with General Additive Modeling and adjusted using inverse probability weighting.

Sex differences in fat mass index (FMI) and lean soft tissue mass showed divergent trajectories between boys and girls from ages 5 to 20 years.

• Girls had higher and increasing median FMI across the age range studied.
• FMI was relatively stable in boys from 5 to 20 years.
• Median LST% only increased in girls between the ages of 10-14 years.
• The increase in LST% was higher and continued from 10 to 18 years in boys.
• Sex differences were described as 'most pronounced for fat and lean soft tissue mass.'

Children of non-European ethnic descent showed higher FMI and differences in LMI compared with children of European descent.

• Ethnic groups with observed differences included children of Cape Verdean, Dutch Antillean, Moroccan, Surinamese-Hindustani, and Turkish descent.
• Higher FMI was observed in these groups compared with children from European descent.
• Differences in LMI were also observed across these ethnic groups.
• The cohort was described as a 'diverse population,' reflecting the multiethnic composition of Rotterdam.

BMD centiles in the current European cohort were similar to North American and Swiss cohorts, but FMI and LMI average reference values were lower.

• Comparison was made with North American and Swiss cohorts.
• Current BMD centiles were described as 'similar' to those of the comparison cohorts.
• FMI average reference values in the current study were lower than in North American and Swiss cohorts.
• LMI average reference values were also lower compared with North American and Swiss cohorts.

The created reference charts are intended to be useful for European populations and clinical studies given the scarcity of existing European pediatric DXA body composition references.

• European pediatric references for DXA-derived body composition measures were described as 'scarce' prior to this study.
• Both age-based reference charts and height-based distribution charts were produced.
• DXA was characterized as 'a fast, relatively safe and efficient modality to estimate body composition.'
• The charts are described as potentially aiding in 'assessing adiposity and cardio-metabolic health.'