Updated reference values for BMD and lean mass measured by DXA in Thai children

Introduction

This study established normative references for total body less head (TBLH) BMD, lumbar spine (L1–L4) BMD, and both total and appendicular lean mass (LM) in Thai children and adolescents (aged 5–18 years) using DXA. This work expands upon 2014 normative data for Thai children, which included L2–L4 BMD, total body BMD (head included), and total LM.

Materials and methods

We reanalyzed total body and lumbar spine DXA scans (Lunar Prodigy Pro, GE Healthcare; enCORE version 7.53) from 174 boys and 193 girls, using upgraded software (enCORE version 17SP2) for TBLH BMD, L1–L4 BMD, and LM analysis. The “enhanced” mode was applied for TBLH BMD and LM. Adjustments for total and appendicular LM were made relative to squared height (m²) to account for body size variability.

Results

Normative data stratified by sex and Tanner stage were generated for TBLH BMD, L1–L4 BMD, and LM indices. Weight and Tanner stage significantly determined BMD and LM. Adolescent girls exhibited higher LSBMD values due to earlier pubertal onset. Boys showed higher LM indices with more rapid gains during growth spurts.

Conclusion

This study provides updated normative reference values for BMD (TBLH and L1–L4) and LM (total and appendicular) in Thai children and adolescents, measured via DXA. These references will enhance the assessment of low bone mass and LM deficits in Thai pediatric populations, particularly in those with chronic illnesses.