NEW YORK (Reuters Health) - In children with cystic fibrosis (CF), bone mineral density is normal before puberty, but a deficit in bone density appears to occur during adolescence and to become more pronounced in adulthood.
"Low BMD (bone mineral density) is recognized in individuals with CF although the pathogenesis remains unclear," Dr. H. M. Buntain, of Royal Children's Hospital in Brisbane, Australia, and colleagues write in the February issue of Thorax.
They compared BMD over a broad continuum of Australian CF patients with healthy controls. In addition, they assessed the association between BMD and clinical parameters, including physical activity, nutrition, and vitamin D. levels.
The researchers used dual energy x-ray absorptiometry to examine BMD of the lumbar spine (LS), total body (TB), femoral neck (FN), cortical wrist (R33%), and distal wrist (RUD) in 153 CF patients (ages 5.3 to 55.8 years) and 149 controls (ages 5.6 to 48.3 years).
Mean BMD was not significantly different between healthy controls and children with CF between the ages of 5 and 10 years. After adjustment for age, sex, and height, the team found that TB and R33% bone mineral density were reduced in adolescents.
The difference in BMD between controls and CF patients were 0.04 g/cm² for TB, and 0.03 g/cm² at R33%.
Among adults, a reduction in BMD was found at all sites except R33%. The differences between control and CF (in g/cm²) were as follows: TB = 0.05, LS = 0.08, FN = 0.09, and RUD = 0.03.
The investigators observed weak associations between BMD and nutritional status and disease severity in children/adolescents.
"Our study supports the advice that children, adolescents, and adults with CF should maintain optimal nutritional status, partake in physical activity, minimize corticosteroid usage, and maximize lung health in order to optimize BMD," Dr. Buntain and colleagues advise.
Source: Thorax 2004;59:149-155. [ Google search on this article ]
MeSH Headings: Musculoskeletal Physiology : Musculoskeletal, Neural, and Ocular Physiology : Bone Density : Biological Sciences
Copyright © 2002 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.