Low bone mineral density in young children with cystic fibrosis

Am J Respir Crit Care Med. 2007 May 1;175(9):951-7. doi: 10.1164/rccm.200606-776OC. Epub 2007 Feb 1.

Abstract

Rationale: Low bone mineral density (BMD) is a frequent problem for adult patients with cystic fibrosis (CF). Only limited information is available for young patients.

Objectives: The aim of this study was to evaluate BMD of children with CF younger than 6 years.

Methods: BMD was measured at the lumbar spine (LS) after adjustment for height, sex, and pubertal status in 25 children with CF younger than 6 years, 53 prepubertal children aged 6 to 10 years, and 36 adolescents aged 11 to 18 years. Nutritional status, body composition, pulmonary disease severity, corticosteroid usage, dietary calcium, caloric intake, and vitamin D status were evaluated as potential correlates of BMD.

Measurements and main results: The mean LS z score in the youngest group was significantly lower than normal (-0.96; SEM, 0.3). It did not differ significantly from that of children aged 6 to 10 years (-0.91; SEM, 0.2) or adolescents (-1.4; SEM, 0.2). LS z score was positively correlated with fat-free mass in multiple regression analysis. LS z score was less than -1 in 34% of the patients with mild pulmonary disease and normal nutritional status.

Conclusions: These data suggest that the origin of CF bone disease in early childhood may be independent of nutritional status or disease severity.

MeSH terms

  • Adolescent
  • Adrenal Cortex Hormones / administration & dosage
  • Age Factors*
  • Body Composition
  • Bone Density*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cohort Studies
  • Cystic Fibrosis / blood
  • Cystic Fibrosis / drug therapy
  • Cystic Fibrosis / physiopathology*
  • Diet
  • Female
  • Humans
  • Male
  • Nutritional Status
  • Severity of Illness Index
  • Vitamin D / blood

Substances

  • Adrenal Cortex Hormones
  • Vitamin D