Bone Mineral Density and Fat-Soluble Vitamin Status in Adults with Cystic Fibrosis Undergoing Lung Transplantation: A Pilot Study
Publication: Canadian Journal of Dietetic Practice and Research
19 July 2016
Abstract
Purpose: Patients with cystic fibrosis (CF) often experience low bone mineral density (BMD) pre- and post-lung transplantation (LTX). The study purpose was to describe BMD and micronutrient status in adults with CF pre- and post-LTX.
Methods: Twelve patients with CF (29 ± 8 years) were recruited from the CF clinic at the University of Alberta Lung Transplant Program. BMD and vitamins A, D, E, K status, and parathyroid hormone were measured pre- and post-LTX.
Results: No significant differences pre- and post-LTX were observed at the different bone sites measured (lumber–spine, femoral–neck (FN), hip, and femoral–trochlea) (P > 0.05). BMD T-scores (<−2) was present in lumbar–spine, FN, hip, and femoral–trochlea in 33%, 17%, 17%, and 25% of individuals pre-LTX and 58%, 33%, 58%, and 33% of individuals post-LTX, respectively. More than 50% of patients had suboptimal vitamin K levels (PIVKA-II values >3 ng/mL) pre- and post-LTX.
Conclusion: Adults with CF pre- and post-LTX had reduced BMD and suboptimal vitamin K status.
Résumé
Objectif. Les patients atteints de fibrose kystique (FK) ont souvent une densité minérale osseuse (DMO) faible avant et après la transplantation pulmonaire (TP). L’objectif de l’étude était de décrire la DMO et l’état nutritionnel en micronutriments des adultes atteints de FK avant et après la TP.
Méthodes. Douze patients atteints de FK (29 ± 8 ans) ont été recrutés à la clinique de FK du programme de transplantation pulmonaire de l’Université de l’Alberta. La DMO et l’état nutritionnel en vitamines A, D, E et K, et l’hormone parathyroïde ont été mesurés avant et après la TP.
Résultats. Aucune différence significative n’a été observée avant et après la TP aux différents sites osseux mesurés (rachis lombaire, col fémoral, hanche et trochlée fémorale) (p > 0,05). Des scores T de la DMO (<−2) étaient présents dans le rachis lombaire, le col fémoral, la hanche et la trochlée fémorale chez 33 %, 17 %, 17 % et 25 % des personnes avant la TP et chez 58 %, 33 %, 58 % et 33 % des personnes après la TP, respectivement. Plus de 50% des patients avaient des taux de vitamine K sous-optimaux (concentrations de PIVKA-II > 3 ng/ml) avant et après la TP.
Conclusion. Les adultes atteints de FK avaient une DMO réduite et un taux de vitamine K sous-optimal avant et après la TP.
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References
1
Elkin SL, Fairney A, Burnett S, Kemp M, Kyd P, Burgess J, et al. Vertebral deformities and low bone mineral density in adults with cystic fibrosis: a cross-sectional study Osteoporos Int 2001 12 5 366 -72
2
Bianchi ML, Romano G, Saraifoger S, Costantini D, Limonta C, and Colombo C BMD and body composition in children and young patients affected by cystic fibrosis J Bone Miner Res 2006 21 3 388 -96
3
Aris RM, Merkel PA, Bachrach LK, Borowitz DS, Boyle MP, Elkin SL, et al. Guide to bone health and disease in cystic fibrosis J Clin Endocrinol Metab 2005 90 3 1888 -96
4
Fok J, Brown NE, Zuberbuhler P, Tabak J, and Tom M Low bone mineral density in cystic fibrosis patients Can J Diet Pract Res 2002 63 4 192 -7
5
Culhane S, George C, Pearo B, and Spoede E Malnutrition in cystic fibrosis: a review Nutr Clin Pract 2013 28 6 676 -83
6
Maqbool A and Stallings VA Update on fat-soluble vitamins in cystic fibrosis Curr Opin Pulm Med 2008 14 6 574 -81
7
Lowery EM, Bemiss B, Cascino T, Durazo-Arvizu RA, Forsythe SM, Alex C, et al. Low vitamin D levels are associated with increased rejection and infections after lung transplantation J Heart Lung Transplant 2012 31 7 700 -7
8
Ho T, Gupta S, Brotherwood M, Robert R, Cortes D, Verjee Z, et al. Increased serum vitamin A and E levels after lung transplantation Transplantation 2011 92 5 601 -6
9
Fidalgo P, Ahmed M, Meyer SR, Lien D, Weinkauf J, Kapasi A, et al. Association between transient acute kidney injury and morbidity and mortality after lung transplantation: a retrospective cohort study J Crit Care 2014 29 6 1028 -34
10
Santana MJ, Feeny D, Jackson K, Weinkauf J, and Lien D Improvement in health-related quality of life after lung transplantation Can Respir J 2009 16 5 153 -8
11
Bertolaso C, Groleau V, Schall JI, Maqbool A, Mascarenhas M, Latham NE, et al. Fat-soluble vitamins in cystic fibrosis and pancreatic insufficiency: efficacy of a nutrition intervention J Pediatr Gastroenterol Nutr 2014 58 4 443 -8
12
Hoffmann MR, Jackson ST, Jindal K, Senior PA, and Mager DR Vitamin D status, body composition and glycemic control in adults with diabetes and chronic kidney disease Eur J Clin Nutr 2015 70 6 743 -749
13
Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline J Clin Endocrinol Metab 2011 96 7 1911 -30
14
Aringer M, Kiener HP, Koeller MD, Artemiou O, Zuckermann A, Wieselthaler G, et al. High turnover bone disease following lung transplantation Bone 1998 23 5 485 -8
15
Mazziotti G, Canalis E, and Giustina A Drug-induced osteoporosis: mechanisms and clinical implications Am J Med 2010 123 10 877 -84
16
Mager DR, Alzaben AS, Roberts C, Gilmour SM, and Yap J Bone mineral density and growth in children having undergone liver transplantation with a corticosteroid-free immunosuppressive protocol JPEN J Parenteral Enteral Nutr 2015 1 -9
17
Paccou J, Fardellone P, and Cortet B Cystic fibrosis-related bone disease Curr Opin Pulm Med 2013 19 6 681 -6
18
Langlois K, Greene-Finestone L, Little J, Hidiroglou N, and Whiting S Vitamin D status of Canadians as measured in the 2007 to 2009 Canadian Health Measures Survey Health Rep 2010 21 1 47 -55
19
Whiting SJ, Langlois KA, Vatanparast H, and Greene-Finestone LS The vitamin D status of Canadians relative to the 2011 Dietary Reference Intakes: an examination in children and adults with and without supplement use Am J Clin Nutr 2011 94 1 128 -35
20
Wang TK, O’Sullivan S, Gamble GD, and Ruygrok PN Bone density in heart or lung transplant recipients – a longitudinal study Transplant Proc 2013 45 6 2357 -65
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Published In
Canadian Journal of Dietetic Practice and Research
Volume 77 • Number 4 • December 2016
Pages: 199 - 202
History
Version of record online: 19 July 2016
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Grace Hubert RD BSc, Theresa Tam Chung RD BSc, Connie Prosser PhD FCACB, Dale Lien MD, Justin Weinkauf MD, Neil Brown MD, Marianne Goodvin RN BNSc, Kathy Jackson RN BNSc, Joan Tabak RN, Josette Salgado RN BNSc, Abeer Salman Alzaben MSc, and Diana R. Mager PhD MSc RD. 2016. Bone Mineral Density and Fat-Soluble Vitamin Status in Adults with Cystic Fibrosis Undergoing Lung Transplantation: A Pilot Study. Canadian Journal of Dietetic Practice and Research.
77(4): 199-202. https://doi.org/10.3148/cjdpr-2016-014
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