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. 2015 Jul;14(4):526-32.
doi: 10.1016/j.jcf.2015.01.011. Epub 2015 Feb 16.

Trends in bone mineral density in young adults with cystic fibrosis over a 15 year period

Melissa S Putman  1 , Joshua F Baker  2 , Ahmet Uluer  3 , Karen Herlyn  4 , Allen Lapey  5 , Leonard Sicilian  6 , Angela Pizzo Tillotson  7 , Catherine M Gordon  8 , Peter A Merkel  2 , Joel S Finkelstein  9
Affiliations

Trends in bone mineral density in young adults with cystic fibrosis over a 15 year period

Melissa S Putman et al. J Cyst Fibros. 2015 Jul.

Abstract

Background: Improvements in clinical care have led to increased life expectancy in patients with cystic fibrosis (CF) over the past several decades. Whether these improvements have had significant effects on bone health in patients with CF is unclear.

Methods: This is a cross-sectional study comparing clinical characteristics and bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DXA) in adults with CF evaluated in 1995-1999 to age-, race-, and gender-matched patients with CF evaluated in 2011-2013 at the same center on calibrated DXA machines.

Results: The cohorts were similar in terms of age, BMI, pancreatic insufficiency, presence of F508del mutation, and reproductive history. In the most recent cohort, pulmonary function was superior, and fewer patients had vitamin D deficiency or secondary hyperparathyroidism. Areal BMD measures of the PA spine, lateral spine, and distal radius were similarly low in the two cohorts.

Conclusions: Although pulmonary function and vitamin D status were better in patients in the present-day cohort, areal BMD of the spine was reduced in a significant number of patients and was no different in patients with CF today than in the late 1990s. Further attention to optimizing bone health may be necessary to prevent CF-related bone disease.

Keywords: Bone turnover markers; Cystic fibrosis; Dual energy X-ray absorptiometry; Osteoporosis; Vitamin D.

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Conflict of interest statement

Disclosures: All authors state that they have no conflicts of interest.

Figures

Figure 1
Figure 1. Percent of patients with normal or reduced PA spine BMD Z-scores in the historic cohort and present-day cohort (p=0.74)
PA, posterior-anterior; BMD, bone mineral density.
Figure 2
Figure 2. Correlations between PA spine BMD and BMI (2a) and urine NTX (2b) among all subjects with CF
PA, posterior-anterior; BMD, bone mineral density; BMI, body mass index; NTX, N-telopeptide; CF, cystic fibrosis
See this image and copyright information in PMC

References

    1. Aris RM, Renner JB, Winders AD, Buell HE, Riggs DB, Lester GE, et al. Increased rate of fractures and severe kyphosis: sequelae of living into adulthood with cystic fibrosis. Ann Intern Med. 1998;128(3):186–93. - PubMed
    1. Henderson RC, Specter BB. Kyphosis and fractures in children and young adults with cystic fibrosis. J Pediatr. 1994;125(2):208–12. - PubMed
    1. Bianchi ML, Romano G, Saraifoger S, Costantini D, Limonta C, Colombo C. BMD and body composition in children and young patients affected by cystic fibrosis. J Bone Miner Res. 2006;21(3):388–96. - PubMed
    1. Conway SP, Morton AM, Oldroyd B, Truscott JG, White H, Smith AH, et al. Osteoporosis and osteopenia in adults and adolescents with cystic fibrosis: prevalence and associated factors. Thorax. 2000;55(9):798–804. - PMC - PubMed
    1. Grey V, Atkinson S, Drury D, Casey L, Ferland G, Gundberg C, et al. Prevalence of low bone mass and deficiencies of vitamins D and K in pediatric patients with cystic fibrosis from 3 Canadian centers. Pediatrics. 2008;122(5):1014–20. - PubMed

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