Low Bone Mineral Density in Cystic Fibrosis Patients

Publication: Canadian Journal of Dietetic Practice and Research
December 2002

Abstract

The goals of this practice-based, observational study were to describe the prevalence of low bone mineral density in patients at the Edmonton Cystic Fibrosis Centre, and to determine if body mass index and previous systemic corticosteroid use of over one month's duration were predictors of low bone mineral density. One hundred and thirteen pediatric and adult patients were studied. Bone mineral density of the lumbar spine region was measured using dual-energy X-ray absorptiometry. A total of 42.5% of patients had a bone mineral density Z-score of less than –1 standard deviation. Low bone mineral density was apparent at nine to 12 years of age, and was most evident in the 20- to 34-year-old group. All but one patient under age 20 with a Z-score of less than –2.5 also had a body mass index below the fifth percentile. A low Z-score was also associated with previous systemic corticosteroid use of over one month's duration (relative risk 1.81, p=0.003). We conclude that low bone mineral density is common in cystic fibrosis patients. Low body mass index percentiles may be used to identify children and adolescents at risk of low bone mineral density. These patients may benefit from aggressive nutrition therapy. Systemic corticosteroid use should be assessed carefully, as it is a risk factor for low bone mineral density.

Résumé

Les buts de cette étude d'observation basée sur la pratique étaient de décrire la prévalence d'une faible densité minérale osseuse chez des patients de l'Edmonton Cystic Fibrosis Centre et de déterminer si l'indice de masse corporelle et l'usage antérieur de corticoïdes généraux pendant plus de un mois pouvaient être des prédicteurs de cette faible densité minérale osseuse. L’étude a porté sur 113 patients, enfants et adultes. La densité minérale osseuse de la colonne lombaire a été mesurée par absorptiométrie biénergétique aux rayons X. Chez 42,5 % des patients, l’écart réduit (score Z) de densité minérale osseuse était inférieur à –1 écart-type. La faible densité minérale osseuse était apparente chez les patients de 9 à 12 ans, et évidente chez ceux de 20 à 34 ans. Tous les patients de moins de 20 ans sauf un ayant un écart réduit de moins de –2,5 écarts-types avaient également un indice de masse corporelle inférieur au cinquième percentile. Un écart réduit faible était également associé à l'usage antérieur de corticoïdes généraux pendant plus de un mois (risque relatif 1,81; p=0,003). Nous avons conclu qu'une faible densité minérale osseuse est courante chez les patients souffrant de fibrose kystique. Les percentiles d'indices de masse corporelle faibles peuvent être utilisés pour repérer les enfants et les adolescents à risque de faible densité minérale osseuse. Ces patients peuvent bénéficier d'un traitement nutritionnel énergique. L'usage de corticoïdes généraux doit être évalué soigneusement, car il constitue un facteur de risque de faible densité minérale osseuse.

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Information & Authors

Information

Published In

cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 63Number 4December 2002
Pages: 192 - 197

History

Version of record online: 12 February 2007

Authors

Affiliations

Jenny Fok, BHEc, RD
Pediatric and Adult Cystic Fibrosis Clinics, University of Alberta Hospital, Edmonton, AB
Neil E. Brown, MD, FRCP(C)
Adult Cystic Fibrosis Clinic, University of Alberta Hospital, Edmonton, AB
Peter Zuberbuhler, MD, FRCP(C)
Pediatric Cystic Fibrosis Clinic, University of Alberta Hospital, Edmonton, AB
Joan Tabak, RN
Pediatric and Adult Cystic Fibrosis Clinics, University of Alberta Hospital, Edmonton, AB
Mei Tom, BSc, RD
Adult Cystic Fibrosis Clinic, University of Alberta Hospital, Edmonton, AB

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Cited by

1. Bone Mineral Density and Fat-Soluble Vitamin Status in Adults with Cystic Fibrosis Undergoing Lung Transplantation: A Pilot Study

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