BMD and Body Composition in Children and Young Patients Affected by Cystic Fibrosis

Longer survival in cystic fibrosis has led to more bone complications. One hundred thirty‐six young patients were studied for 12‐24 months. Low BMD was found in 66%. Fat mass and lean mass were also reduced. Impaired pulmonary function and total steroid dose had the greatest negative influence on bo...

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Veröffentlicht in:Journal of bone and mineral research 2006-03, Vol.21 (3), p.388-396
Hauptverfasser: Bianchi, Maria Luisa, Romano, Giovanna, Saraifoger, Silvia, Costantini, Diana, Limonta, Cristina, Colombo, Carla
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container_end_page 396
container_issue 3
container_start_page 388
container_title Journal of bone and mineral research
container_volume 21
creator Bianchi, Maria Luisa
Romano, Giovanna
Saraifoger, Silvia
Costantini, Diana
Limonta, Cristina
Colombo, Carla
description Longer survival in cystic fibrosis has led to more bone complications. One hundred thirty‐six young patients were studied for 12‐24 months. Low BMD was found in 66%. Fat mass and lean mass were also reduced. Impaired pulmonary function and total steroid dose had the greatest negative influence on bone. Introduction: Low BMD is reported as a frequent complication in adult patients affected by cystic fibrosis (CF), but the available data are less consistent for younger patients. Materials and Methods: This study was designed to evaluate BMD longitudinally over 12‐24 months in a sample of 136 young patients (3‐24 years of age) and to investigate its major determinants. BMC and body composition were also evaluated. Results: BMD (expressed as Z score) of spine and of total body was reduced in 66% of patients. The prevalence of low BMD was the same in children, adolescents, and young adults. The main determinants of BMD were forced expiratory volume in 1 s (FEV1; as an index of pulmonary function), puberty, platelet count (as an index of portal hypertension), and cumulative steroid dose. Changes of FEV1 over time influenced BMD changes. Bone mass, fat mass (FM) and fat‐free (lean) mass (FFM) were reduced in CF patients at both total body and subregions (trunk, limbs). Lean mass influenced BMD of total body and lower limbs, whereas fat mass (and BMI) influenced spine BMD. FEV1 also influenced FFM. Conclusions: Low BMD was present in a significant proportion of CF patients, independent of sex and age. BMD depended on pulmonary function, steroid dose, and presence of advanced liver disease. Pulmonary function and puberty were the main stimuli for the increase of BMD over time. CF also altered body composition, and FFM was influenced by pulmonary function.
doi_str_mv 10.1359/JBMR.051106
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One hundred thirty‐six young patients were studied for 12‐24 months. Low BMD was found in 66%. Fat mass and lean mass were also reduced. Impaired pulmonary function and total steroid dose had the greatest negative influence on bone. Introduction: Low BMD is reported as a frequent complication in adult patients affected by cystic fibrosis (CF), but the available data are less consistent for younger patients. Materials and Methods: This study was designed to evaluate BMD longitudinally over 12‐24 months in a sample of 136 young patients (3‐24 years of age) and to investigate its major determinants. BMC and body composition were also evaluated. Results: BMD (expressed as Z score) of spine and of total body was reduced in 66% of patients. The prevalence of low BMD was the same in children, adolescents, and young adults. The main determinants of BMD were forced expiratory volume in 1 s (FEV1; as an index of pulmonary function), puberty, platelet count (as an index of portal hypertension), and cumulative steroid dose. Changes of FEV1 over time influenced BMD changes. Bone mass, fat mass (FM) and fat‐free (lean) mass (FFM) were reduced in CF patients at both total body and subregions (trunk, limbs). Lean mass influenced BMD of total body and lower limbs, whereas fat mass (and BMI) influenced spine BMD. FEV1 also influenced FFM. Conclusions: Low BMD was present in a significant proportion of CF patients, independent of sex and age. BMD depended on pulmonary function, steroid dose, and presence of advanced liver disease. Pulmonary function and puberty were the main stimuli for the increase of BMD over time. CF also altered body composition, and FFM was influenced by pulmonary function.</description><identifier>ISSN: 0884-0431</identifier><identifier>EISSN: 1523-4681</identifier><identifier>DOI: 10.1359/JBMR.051106</identifier><identifier>PMID: 16491286</identifier><identifier>CODEN: JBMREJ</identifier><language>eng</language><publisher>Washington, DC: John Wiley and Sons and The American Society for Bone and Mineral Research (ASBMR)</publisher><subject>Absorptiometry, Photon ; Adolescent ; Biological and medical sciences ; BMD ; body composition ; Body Mass Index ; Bone Density ; bone mass ; Child ; cystic fibrosis ; Cystic Fibrosis - metabolism ; Cystic Fibrosis - pathology ; Female ; Fundamental and applied biological sciences. 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One hundred thirty‐six young patients were studied for 12‐24 months. Low BMD was found in 66%. Fat mass and lean mass were also reduced. Impaired pulmonary function and total steroid dose had the greatest negative influence on bone. Introduction: Low BMD is reported as a frequent complication in adult patients affected by cystic fibrosis (CF), but the available data are less consistent for younger patients. Materials and Methods: This study was designed to evaluate BMD longitudinally over 12‐24 months in a sample of 136 young patients (3‐24 years of age) and to investigate its major determinants. BMC and body composition were also evaluated. Results: BMD (expressed as Z score) of spine and of total body was reduced in 66% of patients. The prevalence of low BMD was the same in children, adolescents, and young adults. The main determinants of BMD were forced expiratory volume in 1 s (FEV1; as an index of pulmonary function), puberty, platelet count (as an index of portal hypertension), and cumulative steroid dose. Changes of FEV1 over time influenced BMD changes. Bone mass, fat mass (FM) and fat‐free (lean) mass (FFM) were reduced in CF patients at both total body and subregions (trunk, limbs). Lean mass influenced BMD of total body and lower limbs, whereas fat mass (and BMI) influenced spine BMD. FEV1 also influenced FFM. Conclusions: Low BMD was present in a significant proportion of CF patients, independent of sex and age. BMD depended on pulmonary function, steroid dose, and presence of advanced liver disease. Pulmonary function and puberty were the main stimuli for the increase of BMD over time. CF also altered body composition, and FFM was influenced by pulmonary function.</description><subject>Absorptiometry, Photon</subject><subject>Adolescent</subject><subject>Biological and medical sciences</subject><subject>BMD</subject><subject>body composition</subject><subject>Body Mass Index</subject><subject>Bone Density</subject><subject>bone mass</subject><subject>Child</subject><subject>cystic fibrosis</subject><subject>Cystic Fibrosis - metabolism</subject><subject>Cystic Fibrosis - pathology</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Lumbar Vertebrae - diagnostic imaging</subject><subject>Male</subject><subject>pediatrics</subject><subject>Skeleton and joints</subject><subject>Vertebrates: osteoarticular system, musculoskeletal system</subject><issn>0884-0431</issn><issn>1523-4681</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2006</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90DtPwzAQB3ALgWgpTOzICywo5S6OHWdsA-WhViAeA1PkODYYpUmJU6F-e1JaqRvT3fC7h_6EnCIMkfHk6mE8ex4CRwSxR_rIQxZEQuI-6YOUUQARwx458v4LAAQX4pD0UEQJhlL0yct4dk1VVdBxXaxoWs8XtXetqyvqKpp-urJoTPUH3utl9UGfVOtM1Xo6stbo1hQ078ZWvnWaTlzedNP-mBxYVXpzsq0D8ja5eU3vgunj7X06mgaaYSwCoaIoFglXYR4mPMwt5lEIgEUS58yiYZozABNLyTggRlwXNjbSSCYKm4eSDcjFZu-iqb-XxrfZ3HltylJVpl76TMRCMuDQwcsN1N1_vjE2WzRurppVhpCtM8zWGWabDDt9tl27zOem2NltaB043wLltSptoyrt_M7FXCacs87FG_fjSrP67-ZfzwWHEIF1L_wCPcWHEQ</recordid><startdate>200603</startdate><enddate>200603</enddate><creator>Bianchi, Maria Luisa</creator><creator>Romano, Giovanna</creator><creator>Saraifoger, Silvia</creator><creator>Costantini, Diana</creator><creator>Limonta, Cristina</creator><creator>Colombo, Carla</creator><general>John Wiley and Sons and The American Society for Bone and Mineral Research (ASBMR)</general><general>American Society for Bone and Mineral Research</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>200603</creationdate><title>BMD and Body Composition in Children and Young Patients Affected by Cystic Fibrosis</title><author>Bianchi, Maria Luisa ; Romano, Giovanna ; Saraifoger, Silvia ; Costantini, Diana ; Limonta, Cristina ; Colombo, Carla</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3176-6a447695a2b2952bf1b42001d97b3f1e3c5300e7883501145cdf7e8e836dfb283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2006</creationdate><topic>Absorptiometry, Photon</topic><topic>Adolescent</topic><topic>Biological and medical sciences</topic><topic>BMD</topic><topic>body composition</topic><topic>Body Mass Index</topic><topic>Bone Density</topic><topic>bone mass</topic><topic>Child</topic><topic>cystic fibrosis</topic><topic>Cystic Fibrosis - metabolism</topic><topic>Cystic Fibrosis - pathology</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Lumbar Vertebrae - diagnostic imaging</topic><topic>Male</topic><topic>pediatrics</topic><topic>Skeleton and joints</topic><topic>Vertebrates: osteoarticular system, musculoskeletal system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bianchi, Maria Luisa</creatorcontrib><creatorcontrib>Romano, Giovanna</creatorcontrib><creatorcontrib>Saraifoger, Silvia</creatorcontrib><creatorcontrib>Costantini, Diana</creatorcontrib><creatorcontrib>Limonta, Cristina</creatorcontrib><creatorcontrib>Colombo, Carla</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of bone and mineral research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bianchi, Maria Luisa</au><au>Romano, Giovanna</au><au>Saraifoger, Silvia</au><au>Costantini, Diana</au><au>Limonta, Cristina</au><au>Colombo, Carla</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>BMD and Body Composition in Children and Young Patients Affected by Cystic Fibrosis</atitle><jtitle>Journal of bone and mineral research</jtitle><addtitle>J Bone Miner Res</addtitle><date>2006-03</date><risdate>2006</risdate><volume>21</volume><issue>3</issue><spage>388</spage><epage>396</epage><pages>388-396</pages><issn>0884-0431</issn><eissn>1523-4681</eissn><coden>JBMREJ</coden><abstract>Longer survival in cystic fibrosis has led to more bone complications. One hundred thirty‐six young patients were studied for 12‐24 months. Low BMD was found in 66%. Fat mass and lean mass were also reduced. Impaired pulmonary function and total steroid dose had the greatest negative influence on bone. Introduction: Low BMD is reported as a frequent complication in adult patients affected by cystic fibrosis (CF), but the available data are less consistent for younger patients. Materials and Methods: This study was designed to evaluate BMD longitudinally over 12‐24 months in a sample of 136 young patients (3‐24 years of age) and to investigate its major determinants. BMC and body composition were also evaluated. Results: BMD (expressed as Z score) of spine and of total body was reduced in 66% of patients. The prevalence of low BMD was the same in children, adolescents, and young adults. The main determinants of BMD were forced expiratory volume in 1 s (FEV1; as an index of pulmonary function), puberty, platelet count (as an index of portal hypertension), and cumulative steroid dose. Changes of FEV1 over time influenced BMD changes. Bone mass, fat mass (FM) and fat‐free (lean) mass (FFM) were reduced in CF patients at both total body and subregions (trunk, limbs). Lean mass influenced BMD of total body and lower limbs, whereas fat mass (and BMI) influenced spine BMD. FEV1 also influenced FFM. Conclusions: Low BMD was present in a significant proportion of CF patients, independent of sex and age. BMD depended on pulmonary function, steroid dose, and presence of advanced liver disease. Pulmonary function and puberty were the main stimuli for the increase of BMD over time. 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subjects Absorptiometry, Photon
Adolescent
Biological and medical sciences
BMD
body composition
Body Mass Index
Bone Density
bone mass
Child
cystic fibrosis
Cystic Fibrosis - metabolism
Cystic Fibrosis - pathology
Female
Fundamental and applied biological sciences. Psychology
Humans
Longitudinal Studies
Lumbar Vertebrae - diagnostic imaging
Male
pediatrics
Skeleton and joints
Vertebrates: osteoarticular system, musculoskeletal system
title BMD and Body Composition in Children and Young Patients Affected by Cystic Fibrosis
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