在患有囊性纤维化的成年人中,骨硬化度的纵向变化
Reem Jad1, Xiayi Ma1, Sanja Stanojevic2
1Division of Respirology, St. Michael's Hospital, University of Toronto, Toronto, ON M5B 1W8, Canada.
概括
患有囊性纤维化 (CF) 的成年人经历了显著的骨密度损失,特别是在大腿部,从成年早期开始. 这种骨质损失随着年龄的增长而加快,这突显了在这个不断增长的人口中保持骨健康的早期干预的必要性.
科学领域:
- 骨质新陈代谢和疾病
- 肺部医学 肺部医学
- 老年医学 老年医学
背景情况:
- 囊性纤维化 (CF) 患者的生存率提高导致与年龄相关的并发症,如CF相关的骨病.
- 在患有CF的成年人中,长期骨损失的轨迹尚不清楚.
- 骨密度下降是CF老年个体的常见问题.
研究的目的:
- 估计患有CF的成年人骨矿物质密度 (BMD) 的平均年变化率.
- 在这个人群中量化大腿部 (FN) 和腰椎 (LS) 的骨损失.
- 为了确定影响骨密度随时间变化的因素.
主要方法:
- 在2000年至2021年期间,对500名患有CF的成年人 (25-48岁) 的DXA扫描进行了回顾性分析.
- 移植后或启动双酸盐或CFTR调节器治疗后排除扫描.
- 线性混合效应模型用于估计FN和LS的 BMD 年平均变化.
主要成果:
- 观察到 BMD 的统计学上显著的年度下降: -0.008 gm/cm2/yr 在 FN 和 -0.006 gm/cm2/yr 在 LS.
- 到48岁时,与25岁相比,FN的BMD下降了18.8%,LS下降了11%,相对于25岁,BMD下降了18.8%.
- 胰腺功能不充分的个体显示BMD下降的速度更快. 在调整疾病严重程度后,下降仍然显著.
结论:
- 患有CF的成年人比预期的更早地经历了显著的骨质损失,进入成年期时骨密度低于最佳.
- 这种骨损失是渐进的,并且可能会因与更年期相关的雌激素下降而加剧.
- 积极的干预措施对于优化老化CF人口的骨健康至关重要.
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