Osteopenia in adults with cystic fibrosis

Shaw, Nicholas; Bedford, Christopher; Heaf, D P; Carty, Helen; Dutton, John

doi:10.1016/s0002-9343(99)80262-9

Cited by 24 publications

(7 citation statements)

References 2 publications

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“…Our finding of normal BMD/BMC in CF does not support reports from several previous groups5-7 23 24; however, there are several subject selection criterion used in our study which we believe account for our findings. Firstly, we have conducted this analysis in a cohort of patients who clearly were not using systemic corticosteroids on a routine basis.…”

Section: Discussioncontrasting

confidence: 99%

Normal bone mineral density in cystic fibrosis

Hardin¹,

Arumugam²,

Seilheimer³

et al. 2001

Archives of Disease in Childhood

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Background-Osteoporosis has been reported as a complication of cystic fibrosis (CF). Aims-To measure bone mineral density (BMD) in non-acutely ill adults and bone mineral content (BMC) in children with CF. Methods-We analysed data from 28 adults and 13 children with CF. Corticosteroid use was minimal for the year prior to study in both groups. Dual x ray absorptiometry was used to measure total body and regional bone mineral density in adults. In children, whole body BMC was measured. Lean tissue mass (LTM) was also measured in all subjects. There were two control groups: A (matched for LTM and height, in addition to age and gender); and B (matched for age and gender only). Results-There was no diVerence in whole body or regional BMD density between adult CF patients and control A subjects. Both whole body and regional BMD were significantly lower in adult CF patients than in control B subjects. Total body BMD was correlated with body mass index, LTM, and percent fat in both CF and control subjects. There was no significant correlation between total body BMD or regional BMD and either NIH clinical status scores, or pulmonary function tests in adults. There was no diVerence in total body BMC between CF children and control A subjects. Total body BMC was significantly lower in CF children than in control B subjects. There was no correlation between pulmonary function results and BMC in children. Conclusion-Osteopenia and osteoporosis in CF may be caused more by malnutrition and chronic use of intravenous or oral corticosteroids than by a CF related inherent defect in BMD. Appropriate "normal" data should be selected when determining whether or not osteoporosis is present in a CF patient.

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Section: Discussioncontrasting

confidence: 99%

Normal bone mineral density in cystic fibrosis

Hardin¹,

Arumugam²,

Seilheimer³

et al. 2001

Archives of Disease in Childhood

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“…Both measurements are therefore useful, but contribute differently to our knowledge of the skeleton. Another more recent study supports the fact that the reduced areal (two dimensional) bone mass density documented in young patients with cystic fibrosis is due to a combination of decreased volumetric bone mass density and reduced bone size, rather than reduced bone size alone 3. We would therefore suggest that it is important to monitor the skeletal health of patients with cystic fibrosis (starting in childhood), ideally by performing annual bone densitometry.…”

mentioning

confidence: 75%

Cystic fibrosis related low bone density

Haworth

Webb²,

Elkin³

et al. 2000

Archives of Disease in Childhood

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“…Although a few studies have found no relationship between BMD status and respiratory function tests,6 13-14 SK score,6 26 or chest radiographic score,26the papers by Aris and Donovan13 14 were restricted to severely compromised patients with a narrow range of respiratory function. Disease severity has shown important associations with reduced BMD when the former was assessed by respiratory function,9 10 SK score,4 7 8 27 chest radiographic scores,7 9 demand for antibiotic treatment, or BMI status 5…”

Section: Discussionmentioning

confidence: 99%

Osteoporosis and osteopenia in adults and adolescents with cystic fibrosis: prevalence and associated factors

Conway

Morton

Oldroyd

et al. 2000

Thorax

177

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Background-Patients with cystic fibrosis (CF) have many risk factors for reduced bone mineral density (BMD). The aim of this study was to determine the prevalence of osteoporosis and osteopenia in a large cross section of patients and to identify risk factors. Methods-All patients attending the regional centre were invited to participate in the study. Bone mineral density was measured at the lumbar spine, femoral neck, and for total body with a Lunar DPX-L densitometer. Multiple indices of disease severity were investigated, and liver and thyroid function, blood calcium, phosphate, 25-OH vitamin D, follicle stimulating and luteinising hormone, oestradiol, and testosterone levels were measured. Patients completed a four day prospective dietary diary. Exercise was assessed by a seven day activity recall questionnaire. Sexual development and treatment histories were obtained. The relationship between all these variables and BMD measurements was analysed. Results-Sixty six percent of 114 patients assessed had osteopenia or osteoporosis. The Shwachman-Kulczycki (SK) clinical score (higher score = less severe disease) correlated significantly with BMD at the lumbar spine and femoral neck, and with total body BMD (p<0.001). There was a predicted increase of 0.0032 g/cm 2 in lumbar spine BMD for every unit increase in the SK score. Oral steroid use was significantly associated with reduced BMD at the lumbar spine (p = 0.017) and femoral neck (p = 0.027). Conclusions-Osteopenia and osteoporosis are common findings in a heterogeneous population of adults with CF. Patients at most risk are those with severe disease and those who have used corticosteroids. (Thorax 2000;55:798-804)

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Osteopenia in adults with cystic fibrosis

Cited by 24 publications

References 2 publications

Normal bone mineral density in cystic fibrosis

Normal bone mineral density in cystic fibrosis

Cystic fibrosis related low bone density

Osteoporosis and osteopenia in adults and adolescents with cystic fibrosis: prevalence and associated factors

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