Controlled longitudinal study of bone mass accrual in children and adolescents with cystic fibrosis

Buntain, Helen

doi:10.1136/thx.2005.046516

Cited by 76 publications

(53 citation statements)

References 57 publications

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“…Low weight for height in adults with CF occurs particularly in women (40), who also die at a younger age than men (41). A previous study showed that the greatest decline in nutritional status occurs after the onset of puberty, particularly in girls (42), although other studies suggest that deterioration in growth and nutritional status occurs throughout childhood (4,43,44). There is a paucity of body-composition studies in children with CF, and comparison is difficult because of different methodologies used, sexual dimorphism, age ranges, and whether appropriate size adjustments have been applied.…”

Section: Body Compositionmentioning

confidence: 89%

“…There is a paucity of body-composition studies in children with CF, and comparison is difficult because of different methodologies used, sexual dimorphism, age ranges, and whether appropriate size adjustments have been applied. However, several recent studies that used DXA noted a reduction of FM and/or FFM (4,45,46), and Stettler (47) noted a reduction in both FFM by hydrometry and FM by total-body electrical conductivity in boys only, whereas Ahmed et al (48), who used skinfold-thickness measurements, suggested that although both sexes have reduced FM, a reduction of FFM occurs in older boys. To our knowledge, no previous study has used a gold-standard technique to assess body composition in children with CF.…”

Section: Body Compositionmentioning

confidence: 95%

“…When growth has been suboptimal, there is a negative effect on physical activity, appetite, and lung function (2). However, recent research suggests that growth in children with CF has improved (3,4). It is also apparent that with improvements in treatment, life expectancy has increased considerably, and complications such as osteoporosis have become apparent in young adults.…”

Section: Introductionmentioning

confidence: 99%

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Body composition assessed by the 4-component model and association with lung function in 6–12-y-old children with cystic fibrosis

Williams

Wells

Benden

et al. 2010

The American Journal of Clinical Nutrition

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Background: Malnutrition is an indicator of a poor prognosis in patients with cystic fibrosis (CF). Previous body-composition (BC) studies in children with CF used 2-component models (2CMs) to assess fat mass (FM) and fat-free mass (FFM), but to our knowledge no study has used the gold-standard 4-component model (4CM), which allows for a more accurate evaluation of the nature of both elements. Objective: We measured BC by using the 4CM in 6-12-y-old children with CF to 1) compare findings with those of healthy, matched control children and reference data; 2) relate BC to lung spirometry [forced expired volume in 1 s (FEV 1 )]; and 3) compare findings with those from more commonly used 2CM techniques. Design: One hundred clinically stable children with CF (57% girls) aged 6-12 y were measured by using the 4CM. Children with CF underwent spirometry (FEV 1 ). Results: Girls with CF had significantly less FM than did healthy girls, even after adjustment for height and pubertal status; boys with CF had higher body mass index SD scores than did healthy boys. FM in girls was positively associated with the FEV 1 percentage predicted. The 2CM FM was significantly different from the 4CM FM, with differences dependent on sex and condition, although most techniques identified a relation between FM and FEV 1 in girls. Conclusions: Although shorter than healthy children, boys with CF were heavier and had a BC within the normal range; however, girls with CF had lower FM than did healthy girls, and this was associated with poorer lung function. Given the worse prognosis in girls, this finding merits more attention. The reliability of 2CM techniques varied with sex and health status.Am J Clin Nutr 2010;92:1332-43.

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Section: Body Compositionmentioning

confidence: 89%

Section: Body Compositionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Body composition assessed by the 4-component model and association with lung function in 6–12-y-old children with cystic fibrosis

Williams

Wells

Benden

et al. 2010

The American Journal of Clinical Nutrition

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“…Monitoring bone mass and providing preventive care are necessary from childhood through adolescence to minimise CF-related bone disease in adults with CF [8]. Although several cross-sectional studies have examined bone mass in children with CF [8,23], longitudinal determinants of bone health have rarely been studied [24][25][26]. Thus, we aimed to assess the extent of bone health problems in a contemporary cohort of children with CF, to assess changes in bone health to better understand determinants of bone mineral content as assessed by DXA.…”

Section: Discussionmentioning

confidence: 99%

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

Chirita-Emandi

Shepherd

Kyriakou

et al. 2017

Journal of Pediatric Endocrinology and Metabolism

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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

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“…This fact should be given its due weight since the occurrence of this type of fracture during day-to-day activities may be the first sign of osteoporosis. Buntain et al 26 also observed a high prevalence of fractures among adolescents with CF, primarily of vertebrae. Fractures debilitate CF patients, often irreversibly, and when the ribs are fractured this can alter the clinical course by causing chest pain, inhibiting the cough reflex and removal of secretions from the airways, accelerating the decline in pulmonary function.…”

mentioning

confidence: 93%

Prevalência de doença mineral óssea em adolescentes com fibrose cística

Caldeira

Fonseca

Gomes

et al. 2008

J. Pediatr. (Rio J.)

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Objective: To evaluate the prevalence of bone mineral disease among adolescents with cystic fibrosis and to relate the findings with the variables studied. Methods:The study enrolled 37 adolescents who were assessed for: nutritional status according to height/age and body mass/age ratios; bone mineral density of the lumbar spine and entire body by densitometry with dual emission X-ray; daily dietary intake according to a 3-day dietary recall; and pulmonary function by the forced expiratory volume in one second test.Results: Mean age was 13.2 (±2.8) years. Nutritional status was adequate in 70.3 and 75.7% of patients according to the height/age and body mass/age indices, respectively; 54.1% of the patients exhibited reduced lumbar spine bone mineral density and 32.5% for the whole body. There was a positive correlation between bone mineral density and body mass index (p = 0.04). Lung disease and pancreatic insufficiency exhibited a correlation with altered bone mineral density. The dietary recall revealed adequate percentages of calcium, phosphorous and calories, according to the nutritional recommendations laid out in the European Cystic Fibrosis Consensus. The multivariate analysis indicated that these variables were not statistically significant. Conclusions:There is a high prevalence of bone mineral disease among adolescents. Good nutritional status, pancreatic enzyme replacement and control of lung disease may have a protective effect on bone mass.J Pediatr (Rio J). 2008;84(1):18-25: Bone mineral density, cystic fibrosis, adolescents.

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Controlled longitudinal study of bone mass accrual in children and adolescents with cystic fibrosis

Cited by 76 publications

References 57 publications

Body composition assessed by the 4-component model and association with lung function in 6–12-y-old children with cystic fibrosis

Body composition assessed by the 4-component model and association with lung function in 6–12-y-old children with cystic fibrosis

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

Prevalência de doença mineral óssea em adolescentes com fibrose cística

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