Relationship between insulin-like growth factor I, dehydroepiandrosterone sulfate and proresorptive cytokines and bone density in cystic fibrosis

Gordon, Catherine M.; Binello, Emanuela; LeBoff, Meryl S.; Wohl, Mary Ellen B.; Rosen, Clifford J.; Colin, Andrew A.

doi:10.1007/s00198-005-0058-x

Cited by 29 publications

(18 citation statements)

References 56 publications

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“…Twenty-five participants (39%) were found to be vitamin D-deficient (25OHD<37.5 nmol/ L), replicating data from previous studies that showed a high prevalence of vitamin D deficiency among these patients (33)(34)(35)(36). The deficiency was more common during winter: 12 cases identified with mean 25OHD for winter participants of 29.5±20.2 nmol/L vs one case during summer with mean 25OHD for summer participants of 59.8±23.5 nmol/L (P<0.001).…”

Section: Resultssupporting

confidence: 80%

Nutrient Status of Adults with Cystic Fibrosis

Gordon¹,

Anderson²,

Herlyn³

et al. 2007

Journal of the American Dietetic Association

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Nutrition is thought to influence disease status in patients with cystic fibrosis (CF). This crosssectional study sought to evaluate nutrient intake and anthropometric data from 64 adult outpatients with cystic fibrosis. Nutrient intake from food and supplements was compared with the Dietary Reference Intakes for 16 nutrients and outcomes influenced by nutritional status. Attention was given to vitamin D and calcium given potential skeletal implications due to cystic fibrosis. Measurements included weight, height, body composition, pulmonary function, and serum metabolic parameters. Participants were interviewed about dietary intake, supplement use, pulmonary function, sunlight exposure, and pain. The participants' mean body mass index (±standard deviation) was 21.8±4.9 and pulmonary function tests were normal. Seventy-eight percent used pancreatic enzyme replacement for malabsorption. Vitamin D deficiency [25-hydroxyvitamin D (25OHD)<37.5 nmol/L] was common: 25 (39%) were deficient despite adequate vitamin D intake. Lipid profiles were normal in the majority, even though total and saturated fat consumption represented 33.0% and 16.8% of energy intake, respectively. Reported protein intake represented 16.9% of total energy intake (range 10%-25%). For several nutrients, including vitamin D and calcium, intake from food and supplements in many participants exceeded recommended Tolerable Upper Intake Levels. Among adults with cystic fibrosis, vitamin D deficiency was common despite reported adequate intake, and lipid profiles were Copyright © 2007 Significant advances in the management of cystic fibrosis (CF) have increased the lifespan for patients with this common disease (1 in 3,900 white live births) (1). Previous research has suggested that patients with cystic fibrosis who have a good nutritional status have the best chance of maintaining and improving health (1-3). Nutritional therapy itself may also contribute to a better pulmonary status (4,5). A 1992 consensus report (1) emphasized the importance of detecting malnutrition in these patients to ensure optimal therapeutic management. A 2003 expert report on bone disease in cystic fibrosis cited both malnutrition and physical inactivity as risk factors for poor bone health (6).Osteoporosis is a common health problem as patients with cystic fibrosis survive longer (6-11), and one study of patients with this disease showed that decreased bone density was more prevalent in the most malnourished patients (8). A subnormal body mass index (BMI), among other factors, can compromise bone density (6,11,12). A high fracture risk and kyphosis are also documented in these patients (12). Serum vitamin D concentrations may be an important predictor of skeletal health, but the relationship between vitamin D status and bone density remains unclear in this disease (6,9-15).Most reports on nutrition in cystic fibrosis have been reviews, or include data collected in children (16)(17)(18)(19)(20)(21)(22)(23). In this study, anthropometric, nutritional, and lifestyle va...

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Section: Resultssupporting

confidence: 80%

Nutrient Status of Adults with Cystic Fibrosis

Gordon¹,

Anderson²,

Herlyn³

et al. 2007

Journal of the American Dietetic Association

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“…In particular, patients with CF are at risk for rib and vertebral fractures, which can lead to significant morbidity and mortality (6, 7). An unusual pattern of bone turnover has also been described in this patient population, with higher than expected markers of bone resorption and lower than expected markers of bone formation (8, 9). Although the exact pathogenesis of CF-related bone disease is unclear, patients with CF possess multiple risk factors for low bone density, including pancreatic insufficiency, malabsorption, poor nutritional status, vitamin D deficiency, delayed puberty, glucocorticoid use, inflammation, and physical inactivity (10).…”

Section: Introductionsupporting

confidence: 55%

Trends in bone mineral density in young adults with cystic fibrosis over a 15 year period

Putman

Baker

Uluer

et al. 2015

Journal of Cystic Fibrosis

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Background Improvements in clinical care have led to increased life expectancy in patients with cystic fibrosis (CF) over the past several decades. Whether these improvements have had significant effects on bone health in patients with CF is unclear. Methods This is a cross-sectional study comparing clinical characteristics and bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DXA) in adults with CF evaluated in 1995–1999 to age-, race-, and gender matched patients with CF evaluated in 2011–2013 at the same center on calibrated DXA machines. Results The cohorts were similar in terms of age, BMI, pancreatic insufficiency, presence of F508del mutation, and reproductive history. In the most recent cohort, pulmonary function was superior, and fewer patients had vitamin D deficiency or secondary hyperparathyroidism. Areal BMD measures of the PA spine, lateral spine, and distal radius were similarly low in the two cohorts. Conclusions Although pulmonary function and vitamin D status were better in patients in the present-day cohort, areal BMD of the spine was reduced in a significant number of patients and was no different in patients with CF today than in the late 1990s. Further attention to optimizing bone health may be necessary to prevent CF-related bone disease.

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“…Serum IL-6, IL-1, and TNF-α, which suppress bone formation and exacerbate bone resorption, are increased in patients with exacerbated lung infections [150,151]. Serum IGF-1, a bone anabolic factor, is frequently decreased in patients with CF, probably due to a combination of malnutrition and growth hormone insensitivity secondary to overproduction of inflammatory cytokines [151][152][153]. Recent data suggest that calcium absorption is normal in CF, but endogenous fecal losses are significantly increased, affecting net calcium retention in bone [153][154][155][156].…”

Section: Pathogenesismentioning

confidence: 98%

Chronic pediatric inflammatory diseases: Effects on bone

Viswanathan

Sylvester

2007

Rev Endocr Metab Disord

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In children, chronic inflammatory diseases present a significant challenge to long-term skeletal health. These conditions are often associated with poor appetite and suboptimal overall nutrition, altered nutrient utilization, delayed puberty, inactivity, and reduced muscle mass, all of which can alter bone metabolism. In addition, bone cell activity is susceptible to the effects of the immune response that characterizes these diseases. Moreover, drugs used to treat these maladies, notably glucocorticoids, may have negative effects on bone formation and on linear growth in developing children. As a result, predicted peak bone mass may not be achieved, and fracture risk may be increased in the short term or in the future. Studies using primarily dual energy X-ray absorptiometry have documented that deficits in bone mass are common in these diseases. However, there are wide variations in the prevalence of low bone mass, largely due to differences in the characteristics of each study population. Recent studies provide insight into the pathogenesis of decreased bone mass in these conditions. In this paper we will provide an overview of the effects of chronic inflammatory conditions on bone mass in children. We will also present relevant data from adult patients, when pediatric data are scant or not available.

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Relationship between insulin-like growth factor I, dehydroepiandrosterone sulfate and proresorptive cytokines and bone density in cystic fibrosis

Cited by 29 publications

References 56 publications

Nutrient Status of Adults with Cystic Fibrosis

Nutrient Status of Adults with Cystic Fibrosis

Trends in bone mineral density in young adults with cystic fibrosis over a 15 year period

Chronic pediatric inflammatory diseases: Effects on bone

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