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A retrospective analysis of longitudinal changes in bone mineral content in cystic fibrosis
Insights
Bone mineral content decreases over time in most children with cystic fibrosis (CF). Factors like lung function and vitamin D levels impact bone health, suggesting targets for intervention.
Area of Science:
- Pediatrics
- Bone Metabolism
- Cystic Fibrosis Research
Background:
- Cystic Fibrosis (CF) is associated with suboptimal bone health.
- Longitudinal changes in bone mineral content (BMC) and influencing factors in pediatric CF patients require detailed description.
Purpose of the Study:
- To investigate the longitudinal changes in bone mineral content (BMC) in children with cystic fibrosis (CF).
- To identify factors influencing bone mineral content (BMC) over time in this population.
Main Methods:
- Dual-energy X-ray absorptiometry (DXA) was used to assess bone mineral content standard deviation score (LSBMCSDS) in 100 children over 10 years.
- Retrospective collection of disease markers, anthropometry, and bone biochemistry data.
- LSBMCSDS was adjusted for age, gender, ethnicity, and bone area.
Main Results:
- Most children with CF exhibited suboptimal baseline bone mineral content (BMC) or decreasing values over time.
- Lower forced expiratory volume in 1 second percent (FEV1%), low body mass index standard deviation scores (BMI SDS), and vitamin D levels were associated with BMC reduction.
- Despite individual decreases, the mean LSBMCSDS did not show a statistically significant decline over the study period.
Conclusions:
- Bone mineral content (BMC) is frequently suboptimal and tends to decrease over time in children with cystic fibrosis (CF).
- Pulmonary function (FEV1%), nutritional status (BMI SDS), and vitamin D levels are key factors influencing bone health in CF.
- Addressing these identified parameters presents opportunities to improve bone health outcomes in pediatric CF patients.
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 index standard deviation scores (BMI SDS) and vitamin D were associated with reduction in BMC.
Conclusions:
Bone mineral content as assessed by DXA is sub-optimal and decreases with time in most children with CF and this study has highlighted parameters that can be addressed to improve bone health.
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