A retrospective analysis of longitudinal changes in bone mineral content in cystic fibrosis

Abstract

Background: We aimed to describe the longitudinal changes in bone mineral content and influencing factors, in children with cystic fibrosis (CF). Methods: One hundred children (50 females) had dual X-ray absorptiometry (DXA) performed. Of these, 48 and 24 children had two to three scans, respectively over 10 years of follow-up. DXA data were expressed as lumbar spine bone mineral content standard deviation score (LSBMCSDS) adjusted for age, gender, ethnicity and bone area. Markers of disease, anthropometry and bone biochemistry were collected retrospectively. Results: Baseline LSBMCSDS was > 0.5 SDS in 13% children, between − 0.5; 0.5 SDS, in 50% and ≤ − 0.5 in the remainder. Seventy-eight percent of the children who had baseline LSBMCSDS > − 0.5, and 35% of the children with poor baseline (LSBMCSDS < − 0.5), showed decreasing values in subsequent assessments. However, mean LS BMC SDS did not show a significant decline in subsequent assessments (− 0.51; − 0.64; − 0.56; p = 0.178). Lower forced expiratory volume in 1 s percent (FEV1%) low body mass

What Is New in Pediatric Bone Health

“…32 Recommendations for dietary, activity, and DEXA scan monitoring were included. 32 Patients with altered bone metabolism due to chronic medical conditions, such as type 1 diabetes, 32 various cancers, [33][34][35][36][37][38] cystic fibrosis, 39,40 epilepsy, 41,42 inflammatory bowel disease, 43 chronic kidney disease, 44 Marfan, 45 and restrictive food diets, 46 are likely at increased risk for fracture.…”

Endocrine aspects in cystic fibrosis

“…Importantly, lower forced expiratory volume in 1 s percent (FEV1%) low body mass index standard deviation scores (BMI SDS) and vitamin D were associated with reduction in BMC. The authors conclude that mineral content as assessed by DXA was suboptimal and decreased with time in children with CF at one center [5].…”

A Clinician’s guide to vitamin D supplementation for patients with cystic fibrosis

“…Biochemically, the increase in PTH to maintain calcium homeostasis occurs at the expense of bone demineralization and potentially increased risk of fracture [23] . Variations in the PTH thresholds exist to define hyperparathyroidism and studies suggest that a combined assessment of 25-hydroxyvitamin D levels and PTH are needed to fully assess the risk of compromised bone health [24] .…”