Well-nourished cystic fibrosis patients have normal mineral density, but reduced cortical thickness at the forearm

Louis, Olivia; Clerinx, P.; Gies, Inge; Wachter, Elke De; Schepper, Jean De

doi:10.1007/s00198-008-0646-7

Cited by 14 publications

(12 citation statements)

References 31 publications

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“…Brookes and coworkers finding of larger bone deficits in post‐pubertal children with CF compared to pre‐pubertal children with CF are consistent with our results . Histomorphometric data suggest that adult patients with CF have lower cortical and trabecular bone mass, with low bone turnover and significant decreases in bone formation at the cellular level compared with healthy controls . Putman and colleagues reported that young adults with CF have smaller bone area and lower vBMD at the radius and tibia and have compromised bone microarchitecture at these two sites based on HR‐pQCT results .…”

Section: Discussionsupporting

confidence: 90%

Peripheral quantitative computed tomography (pQCT) bone measurements in children with cystic fibrosis

et al. 2015

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Background: Individuals with cystic fibrosis (CF) have low bone density and increased fracture risk. Methods: Cross-sectional study investigating whole body bone mineral content (WBBMC), bone geometry and strength in 12 children with CF compared to 23 age-and sexmatched controls with and without adjusting for age, height, and body composition. Results: CF group had lower WBBMC than controls (P ¼ 0.007) with larger differences at older ages (age-by-group, P ¼ 0.08). CF group had decreased height (P ¼ 0.006), a trend of lower lean mass per height (P ¼ 0.08), and no difference in relationship between WBBMC and lean mass compared to controls (P ¼ 0.65). Periosteal and endosteal circumferences were smaller in CF (each, P ¼ 0.02). Positive relationships of cortical area and bone strength with age were attenuated with CF (group-by-age; each, P < 0.01). Conclusion: Children with CF have similar WBBMC relative to lean mass as controls. Cortical bone area and bone strength were less in CF group compared to controls, with greater differences in older children. Pediatr Pulmonol.

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Section: Discussionsupporting

confidence: 90%

Peripheral quantitative computed tomography (pQCT) bone measurements in children with cystic fibrosis

et al. 2015

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“…However, these children had significantly lower mean pQCT trabecular vBMD Z-scores and significantly greater cortical vBMD Z-scores than the reference population [17]. Similar discrepancies between DXA and pQCT have been seen in studies of pediatric patients with Crohn disease and cystic fibrosis [18, 19]. …”

Section: Introductionmentioning

confidence: 78%

Skeletal outcomes by peripheral quantitative computed tomography and dual-energy X-ray absorptiometry in adolescent girls with anorexia nervosa

et al. 2016

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Summary We conducted the first comparison of dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) outcomes in adolescent girls with anorexia nervosa. We observed deficits in bone density by both tools. pQCT assessments were associated with many of the same clinical parameters as have been previously established for DXA. Introduction Adolescents with anorexia nervosa (AN) commonly exhibit bone loss, but effects on bone geometry are less clear. We compared measures obtained by DXA and pQCT in girls with AN. Methods Seventy females (age 15.5 ± 1.9 years ) with AN and 132 normal-weighted controls underwent tibial measures by pQCT including trabecular volumetric bone mineral density (vBMD) at the 3 % site, cortical vBMD and dimensions at the 38 % site, and muscle cross-sectional area (CSA) at the 66 % site. Participants with AN also underwent standard DXA measures. Independent t tests compared the pQCT results, while Pearson coefficient assessed correlations among DXA and pQCT measures. Results Trabecular vBMD Z-scores were lower in AN compared to controls (AN −0.31 ± 1.42 vs +0.11 ± 1.01, p = 0.01) and cortical vBMD Z-scores were higher (AN +0.18 ± 0.92 vs −0.50 ± 0.88, p < 0.001). Trabecular vBMD and cortical CSA Z-scores positively correlated with DXA BMD Z-scores (r range 0.57–0.82, p < 0.001). Markers of nutritional status positively correlated with Z-scores for trabecular vBMD, cortical CSA, section modulus, and muscle CSA (p < 0.04 for all). Conclusions This study is the first to compare DXA and pQCT measurements in adolescent girls with AN. We observed deficits in BMD by both DXA and pQCT. pQCT assessments correlated well with DXA bone and body composition measures and were associated with many of the same clinical parameters and disease severity markers as have been previously established for DXA. The differences in cortical vBMD merit further study.

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“…3 However, the true prevalence of CFRBD is likely much higher given that early disease is asymptomatic, adherence to screening guidelines is unknown, and commonly used screening tests may lack sensitivity in detecting early disease. 40,41 Reductions in BMD have been reported in children with CF, [42][43][44][45] but prevalence and severity of CFRBD increase with age and worsening general health status. Rates of reduced BMD in heterogeneous adult populations with CF range from 34 to 67%.…”

Section: Epidemiologymentioning

confidence: 99%

Diabetes Mellitus and Bone Disease in Cystic Fibrosis

Curran

McArdle

Talwalkar

2009

Semin Respir Crit Care Med

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Patients with cystic fibrosis are frequently affected with pancreatic insufficiency and are predisposed to the development of diabetes mellitus (DM) and bone demineralization. Cystic fibrosis-related diabetes mellitus is a clinical entity distinct from type 1 and type 2 diabetes, with important implications for the nutritional and pulmonary health of cystic fibrosis patients. This form of diabetes owes largely to insulin deficiency, but alterations in insulin sensitivity and hepatic glucose production have also been described. Therapy for cystic fibrosis-related diabetes differs substantially from type 2 DM, with careful attention to prandial glycemic excursions crucial to controlling its metabolic effects. Bone disease, including osteopenia and osteoporosis, also occurs with increased frequency in cystic fibrosis, owing to defects in intestinal absorption, chronic inflammation, lung disease, low body weight, and gonadal dysfunction. The pathogenesis, implications, diagnosis, and therapy of cystic fibrosis-related bone demineralization are discussed, with attention to recommended approaches to prevention of and treatment of established bone disease.

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Well-nourished cystic fibrosis patients have normal mineral density, but reduced cortical thickness at the forearm

Abstract: Adolescents and young adults with cystic fibrosis, presenting with only a slight degree of underweight, have at the radius a preserved bone mineral density but a reduced cortical thickness.

Cited by 14 publications

References 31 publications

Peripheral quantitative computed tomography (pQCT) bone measurements in children with cystic fibrosis

Peripheral quantitative computed tomography (pQCT) bone measurements in children with cystic fibrosis

Skeletal outcomes by peripheral quantitative computed tomography and dual-energy X-ray absorptiometry in adolescent girls with anorexia nervosa

Diabetes Mellitus and Bone Disease in Cystic Fibrosis

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