The Choice of Normative Pediatric Reference Database Changes Spine Bone Mineral Density Z-Scores But Not the Relationship Between Bone Mineral Density and Prevalent Vertebral Fractures

OBJECTIVES: Our objectives were to assess the magnitude of the disparity in lumbar spine bone mineral density (LSBMD) Z-scores generated by different reference databases and to evaluate whether the relationship between LSBMD Z-scores and vertebral fractures (VF) varies by choice of database. PATIENTS AND DESIGN: Children with leukemia underwent LSBMD by cross-calibrated dual-energy x-ray absorptiometry, with Z-scores generated according to …