Factors that influence bone mass of healthy children and adolescents measured by quantitative ultrasound at the hand phalanges: a systematic review

Objective:To analyze the main factors that influence bone mass in children and teenagers assessed by quantitative ultrasound (QUS) of the phalanges.Data source:A systematic literature review was performed according to the PRISMA method with searches in databases Pubmed/Medline, SciELO and Bireme for the period 2001-2012, in English and Portuguese languages, using the keywords: children, teenagers, adolescent, ultrasound finger phalanges, quantitative ultrasound of phalanges, phalangeal quantitative ultrasound.Data synthesis:21 articles were included. Girls had, in QUS, Amplitude Dependent Speed of Sound (AD-SoS) values higher than boys during pubertal development. The values of the parameters of QUS of the phalanges and dual-energy X-ray Absorptiometry (DXA) increased with the increase of the maturational stage. Anthropometric variables such as age, weight, height, body mass index (BMI), lean mass showed positive correlations with the values of QUS of the phalanges. Physical activity has also been shown to be positively associated with increased bone mass. Factors such as ethnicity, genetics, caloric intake and socioeconomic profile have not yet shown a conclusive relationship and need a larger number of studies.Conclusions:QUS of the phalanges is a method used to evaluate the progressive acquisition of bone mass during growth and maturation of individuals in school phase, by monitoring changes that occur with increasing age and pubertal stage. There were mainly positive influences variables of sex, maturity, height, weight and BMI, with similar data when compared to the gold standard method, the DXA.

研究目标：分析通过指骨定量超声（quantitative ultrasound, QUS）评估的儿童及青少年骨量的主要影响因素。
数据来源：本研究依据系统综述与Meta分析优先报告条目（PRISMA）标准开展系统文献检索，检索范围涵盖PubMed/Medline、SciELO及Bireme数据库，检索时限为2001年至2012年，语言限定为英语与葡萄牙语，检索关键词包括：儿童、青少年、青春期个体、手指指骨超声、指骨定量超声、指骨定量超声。
数据综合：最终纳入21篇文献。青春期发育阶段，女性的指骨定量超声振幅依赖声速（Amplitude Dependent Speed of Sound, AD-SoS）检测值高于男性。指骨定量超声参数与双能X线吸收法（dual-energy X-ray Absorptiometry, DXA）的检测值均随成熟阶段提升而升高。人体测量学指标如年龄、体质量、身高、体质量指数（body mass index, BMI）及瘦体重与指骨定量超声检测值呈正相关。研究同时证实，体力活动与骨量增加呈正相关。种族、遗传因素、热量摄入及社会经济状况等因素与骨量的关联尚未得到明确结论，仍需开展更大样本量的研究。
结论：指骨定量超声是一种通过监测随年龄及青春期阶段变化的相关指标，评估学龄期个体生长发育过程中骨量渐进性积累的检测方法。性别、成熟程度、身高、体质量及体质量指数为主要正向影响因素，其检测结果与金标准方法双能X线吸收法（DXA）的数据具有一致性。