Bone mineral density, pulmonary function, chronological age, and age at diagnosis in children and adolescents with cystic fibrosis

Donadio, Márcio Vinı́cius Fagundes; Souza, Guilherme Cardenaz de; Tiecher, Gabriele; Heinzmann‐Filho, João Paulo; Paim, Taísa Frescura; Hommerding, Patrícia Xavier; Marostica, Paulo J.C.

doi:10.1016/j.jped.2013.03.008

Cited by 16 publications

(9 citation statements)

References 24 publications

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“…For females, the R 2 explains 19% in both the BMD and BMC. In fact, in some previous studies, researchers have verified that a decrease in PEF correlates to a low BMD in children and adolescents with chronic obstructive pulmonary disease (COPD) [ 3 , 33 , 34 ]. These results a are consistent with studies carried out in adults without COPD [ 10 , 11 ].…”

Section: Discussionmentioning

confidence: 99%

Hand grip strength and maximum peak expiratory flow: determinants of bone mineral density of adolescent students

et al. 2018

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BackgroundMaintaining and building healthy bones during the lifetime requires a complicated interaction between a number of physiological and lifestyle factors. Our goal of this study was to analyze the association between hand grip strength and the maximum peak expiratory flow with bone mineral density and content in adolescent students.MethodsThe research team studied 1427 adolescent students of both sexes (750 males and 677 females) between the ages of 11.0 and 18.9 years in the Maule Region of Talca (Chile). Weight, standing height, sitting height, hand grip strength (HGS), and maximum peak expiratory flow (PEF) were measured. Furthermore, bone mineral density (BMD) and total body bone mineral content (BMC) were determined by using the Dual-Energy X-Ray Absorptiometry (DXA). Hand grip strength and PEF were categorized in tertiles (lowest, middle, and highest). Linear regression was performed in steps to analyze the relationship between the variables. Differences between categories were determined through ANOVA.ResultsIn males, the hand grip strength explained 18–19% of the BMD and 20–23% of the BMC. For the females, the percentage of variation occurred between 12 and 13% of the BMD and 17–18% of the BMC. The variation of PEF for the males was observed as 33% of the BMD and 36% of the BMC. For the females, both the BMD and BMC showed a variation of 19%. The HGS and PEF were divided into three categories (lowest, middle, and highest). In both cases, significant differences occurred in bone density health between the three categories.ConclusionsIn conclusion, the HGS and the PEF related positively to the bone density health of both sexes of adolescent students. The adolescents with poor values for hand grip strength and expiratory flow showed reduced values of BMD and BMC for the total body. Furthermore, the PEF had a greater influence on bone density health with respect to the HGS of the adolescents of both sexes.

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Section: Discussionmentioning

confidence: 99%

Hand grip strength and maximum peak expiratory flow: determinants of bone mineral density of adolescent students

et al. 2018

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“…With improved life expectancy in cystic fibrosis (CF), other complications become apparent, such as liver disease, CF‐related diabetes, and low bone mineral density (BMD). Low BMD and osteoporosis are known complications, associated with increased risk of fractures and decreased quality of life (QOL) 1 …”

Section: Introductionmentioning

confidence: 99%

Understanding the interplay between factors that influence bone mineral density in CF

Gur

Bar‐Yoseph

Diab

et al. 2020

Pediatric Pulmonology

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Background and Objectives Multiple factors affect bone mineral density (BMD) in cystic fibrosis (CF). Our aim was to perform comprehensive analyses of parameters potentially contributing to BMD. Methods A prospective single‐center study assessing BMD, and correlations with multiple parameters including pancreatic status, lung functions, 6‐minute walk test (6MWT), clinical score (modified Shwachman‐Kulczycki [SK] score), vitamin D, nutritional intake, hand grip strength (HGS), habitual physical activity (smart watches), and quality of life (SF‐36 questionnaire). Results Forty CF patients, mean age 18.3 ± 8.1 years, forced expiratory volume in 1 second 74.7% ± 17.9% predicted. Fifteen (37.5%) and 11 (27.5%) had osteopenia and osteoporosis, respectively. BMD was similar in pancreatic sufficient (pancreatic sufficient [PS], n = 15) and insufficient (pancreatic insufficient [PI], n = 25); median hip z score −1.5 ((−2.7)−(+0.2)) vs −1.5 ((−3.5)−(+0.7)), P = .79; spine −0.8 ((−2.2)−(+2)) vs −1.2 ((−4.4)−(+1.5)), P = .39 in PS vs PI, respectively. BMD correlated with HGS (r = .72, P < .001 hip; r = .52, P = .001 spine) and fat‐free mass index (r = .81, P < .001 hip; r = .63, P < .001 spine). BMD z score correlated weakly with SK score and moderately with SF‐36 general health. Data from smart watches, nutrition questionnaires, and 6MWT did not correlate with BMD. In a multivariate model, age and SK score predicted spine z score BMD. Conclusions A substantial number of CF patients have low BMD. Similar rates in PS and PI suggest that other factors, such as disease severity, may contribute to low BMD. SK and age, which can easily be obtained even with limited resources, were the best predictors of low BMD. Further larger multicenter studies are warranted to evaluate the contribution of multifactorial etiologies to low BMD in CF.

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“…This is the largest study exploring the effects of CF and disease severity on bone health outcomes in children with CF. 8,9,18 In a large population of young Australian patients with CF, we found that the prevalence of severely low BMD (z score less than −2) was 15.8%. The prevalence of low BMD in this study was in line with a similar, recent study conducted on Polish children and adolescents, 8 which found 17% of their CF patients had very low BMD (Z-score <−2).…”

Section: Discussionmentioning

confidence: 85%

Bone mineral density is related to lung function outcomes in young people with cystic fibrosis—A retrospective study

Smith

Lim

Yap

et al. 2017

Pediatric Pulmonology

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Bone mineral density, pulmonary function, chronological age, and age at diagnosis in children and adolescents with cystic fibrosis

Abstract: Most patients had BMD within normal limits and presented a positive correlation with pulmonary function, as well as a negative correlation with chronological age and age at diagnosis.

Cited by 16 publications

References 24 publications

Hand grip strength and maximum peak expiratory flow: determinants of bone mineral density of adolescent students

Hand grip strength and maximum peak expiratory flow: determinants of bone mineral density of adolescent students

Understanding the interplay between factors that influence bone mineral density in CF

Bone mineral density is related to lung function outcomes in young people with cystic fibrosis—A retrospective study

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