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Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Low bone mineral density in adults with complex congenital heart disease
Camilla Sandberg1, Karna Johansson2, Christina Christersson3
1Department of Public Health and Clinical Medicine, Umeå University, Sweden; Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Sweden.
Insights
Adults with complex congenital heart disease (CHD) show reduced bone mineral content (BMC) and bone mineral density (BMD), indicating premature aging. This highlights the need for proactive osteoporosis screening and management in this population.
Area of Science:
- Cardiology
- Gerontology
- Bone Metabolism
Background:
- Advances in medical care allow more children with complex congenital heart disease (CHD) to survive into adulthood.
- Adults with CHD experience premature aging, with increased incidence of heart failure, dementia, cancer, and sarcopenia.
- The impact of complex CHD on bone structure and premature aging of bone is not well understood.
Purpose of the Study:
- To investigate bone mineral content (BMC) and bone mineral density (BMD) in adults with complex CHD.
- To determine if adults with complex CHD exhibit signs of premature bone aging.
Main Methods:
- Dual-energy X-ray absorptiometry (DXA) was used to assess total body BMC and BMD.
- 73 adults with complex CHD were compared with 73 age- and sex-matched healthy controls.
Main Results:
- Adults with complex CHD had significantly lower total body BMC and BMD compared to controls.
- Reduced bone mineral density (BMD) was observed in patients with single ventricle physiology and other complex diagnoses.
- These findings persisted even after correcting for common osteoporosis risk factors.
Conclusions:
- Adults with complex CHD exhibit reduced BMC and BMD, consistent with other signs of premature aging.
- While osteoporosis risk is currently low in this younger population, it is expected to increase with age.
- Clinicians should monitor osteoporosis risk factors and utilize DXA scans to prevent fractures in adults with complex CHD.
Aims:
The majority of children with complex congenital heart disease (CHD) survive into adulthood due to advances in medical care. Adult patients with CHD have an increased incidence of diagnoses related to ageing such as heart failure, dementia, cancer and sarcopenia, despite a relatively low age. They also have a shorter life expectancy. It is unknown if their bone structures also show signs of premature ageing. We therefore investigated Bone Mineral Content (BMC) and bone mineral density (BMD) in an adult population with complex CHD.
Methods:
The total body BMC and BMD was examined using dual energy X-ray absorptiometry (DXA) in 73 adults with complex CHD (mean age 35.8 ± 14.3, women n = 22) and 73 age and sex matched controls.
Results:
The adults with complex CHD had lower total body BMC (2.6 ± 0.5 kg vs. 2.9 ± 0.5 kg, p < 0.001) and BMD (1.18 ± 0.12 g/cm2vs. 1.26 ± 0.11 g/cm2, p < 0.001) compared to controls. BMD was lower for patients with single ventricle physiology and for the other complex diagnoses, and it persisted after correction for most common risk factors for osteoporosis.
Conclusion:
Adults with complex CHD have reduced total body BMC and BMD compared to healthy controls. These results are a sign of frailty that conforms with other previously reported signs of premature ageing. The risk of osteoporosis is low in our relatively young population, but it is assumed to increase with ageing. We recommend that clinicians pay close attention to risk factors for osteoporosis, and are generous in administering DXA-measurements in order to prevent future fractures among adults with complex CHD.
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