Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1993 Jun;48(6):589–593. doi: 10.1136/thx.48.6.589

Bone mineral density and body composition in adult patients with cystic fibrosis.

A B Grey 1, R W Ames 1, R D Matthews 1, I R Reid 1
PMCID: PMC464571  PMID: 8346485

Abstract

BACKGROUND--Cystic fibrosis is a multisystem disease characterised by chronic pulmonary sepsis and malnutrition. To ascertain whether osteoporosis is a feature of cystic fibrosis in adult patients, total body and regional bone mineral density (BMD) was measured in a group of eight men and eight women aged 17-42 years. METHODS--Total body and regional BMD (lumbar spine L2-L4, femoral neck, trochanteric, and Ward's triangle), as well as total body fat and lean mass, were measured by dual energy x ray absorptiometry. A range of biochemical, lifestyle, and anthropometric variables was also assessed. RESULTS--Patients with cystic fibrosis had significantly reduced bone density at all sites compared with normal young adults. The mean reductions ranged from 7% at Ward's triangle to 13% at the trochanter. Body mass index (BMI) was positively correlated with BMD at four sites and disease severity negatively correlated with BMD at two sites. Other biochemical and anthropometric variables were not predictive of bone density. Total body fat mass was reduced by 30% compared with normal young adults. CONCLUSIONS--Bone density is decreased in adult patients with cystic fibrosis and BMI and disease severity are independent predictors of bone density.

Full text

PDF
589

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Angus R. M., Sambrook P. N., Pocock N. A., Eisman J. A. A simple method for assessing calcium intake in Caucasian women. J Am Diet Assoc. 1989 Feb;89(2):209–214. [PubMed] [Google Scholar]
  2. Bonjour J. P., Theintz G., Buchs B., Slosman D., Rizzoli R. Critical years and stages of puberty for spinal and femoral bone mass accumulation during adolescence. J Clin Endocrinol Metab. 1991 Sep;73(3):555–563. doi: 10.1210/jcem-73-3-555. [DOI] [PubMed] [Google Scholar]
  3. Cann C. E., Martin M. C., Genant H. K., Jaffe R. B. Decreased spinal mineral content in amenorrheic women. JAMA. 1984 Feb 3;251(5):626–629. [PubMed] [Google Scholar]
  4. Desmond K. J., Schwenk W. F., Thomas E., Beaudry P. H., Coates A. L. Immediate and long-term effects of chest physiotherapy in patients with cystic fibrosis. J Pediatr. 1983 Oct;103(4):538–542. doi: 10.1016/s0022-3476(83)80579-4. [DOI] [PubMed] [Google Scholar]
  5. Fitton A., McTavish D. Pamidronate. A review of its pharmacological properties and therapeutic efficacy in resorptive bone disease. Drugs. 1991 Feb;41(2):289–318. doi: 10.2165/00003495-199141020-00009. [DOI] [PubMed] [Google Scholar]
  6. Foresta C., Ruzza G., Mioni R., Meneghello A., Baccichetti C. Testosterone and bone loss in Klinefelter syndrome. Horm Metab Res. 1983 Jan;15(1):56–57. doi: 10.1055/s-2007-1018630. [DOI] [PubMed] [Google Scholar]
  7. Gibbens D. T., Gilsanz V., Boechat M. I., Dufer D., Carlson M. E., Wang C. I. Osteoporosis in cystic fibrosis. J Pediatr. 1988 Aug;113(2):295–300. doi: 10.1016/s0022-3476(88)80268-3. [DOI] [PubMed] [Google Scholar]
  8. Hahn T. J., Squires A. E., Halstead L. R., Strominger D. B. Reduced serum 25-hydroxyvitamin D concentration and disordered mineral metabolism in patients with cystic fibrosis. J Pediatr. 1979 Jan;94(1):38–42. doi: 10.1016/s0022-3476(79)80346-7. [DOI] [PubMed] [Google Scholar]
  9. Huang N. N., Schidlow D. V., Szatrowski T. H., Palmer J., Laraya-Cuasay L. R., Yeung W., Hardy K., Quitell L., Fiel S. Clinical features, survival rate, and prognostic factors in young adults with cystic fibrosis. Am J Med. 1987 May;82(5):871–879. doi: 10.1016/0002-9343(87)90147-1. [DOI] [PubMed] [Google Scholar]
  10. Julian B. A., Laskow D. A., Dubovsky J., Dubovsky E. V., Curtis J. J., Quarles L. D. Rapid loss of vertebral mineral density after renal transplantation. N Engl J Med. 1991 Aug 22;325(8):544–550. doi: 10.1056/NEJM199108223250804. [DOI] [PubMed] [Google Scholar]
  11. Kelly P. J., Atkinson K., Ward R. L., Sambrook P. N., Biggs J. C., Eisman J. A. Reduced bone mineral density in men and women with allogeneic bone marrow transplantation. Transplantation. 1990 Nov;50(5):881–883. [PubMed] [Google Scholar]
  12. Landon C., Rosenfeld R. G. Short stature and pubertal delay in male adolescents with cystic fibrosis. Androgen treatment. Am J Dis Child. 1984 Apr;138(4):388–391. doi: 10.1001/archpedi.1984.02140420054017. [DOI] [PubMed] [Google Scholar]
  13. Mazess R. B., Barden H. S., Bisek J. P., Hanson J. Dual-energy x-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. Am J Clin Nutr. 1990 Jun;51(6):1106–1112. doi: 10.1093/ajcn/51.6.1106. [DOI] [PubMed] [Google Scholar]
  14. Mazess R. B., Barden H. S. Bone density in premenopausal women: effects of age, dietary intake, physical activity, smoking, and birth-control pills. Am J Clin Nutr. 1991 Jan;53(1):132–142. doi: 10.1093/ajcn/53.1.132. [DOI] [PubMed] [Google Scholar]
  15. Mazess R. B., Barden H. S., Drinka P. J., Bauwens S. F., Orwoll E. S., Bell N. H. Influence of age and body weight on spine and femur bone mineral density in U.S. white men. J Bone Miner Res. 1990 Jun;5(6):645–652. doi: 10.1002/jbmr.5650050614. [DOI] [PubMed] [Google Scholar]
  16. Melton L. J., 3rd, Kan S. H., Wahner H. W., Riggs B. L. Lifetime fracture risk: an approach to hip fracture risk assessment based on bone mineral density and age. J Clin Epidemiol. 1988;41(10):985–994. doi: 10.1016/0895-4356(88)90036-4. [DOI] [PubMed] [Google Scholar]
  17. Mischler E. H., Chesney P. J., Chesney R. W., Mazess R. B. Demineralization in cystic fibrosis detected by direct photon absorptiometry. Am J Dis Child. 1979 Jun;133(6):632–635. doi: 10.1001/archpedi.1979.02130060072016. [DOI] [PubMed] [Google Scholar]
  18. Norman D., Elborn J. S., Cordon S. M., Rayner R. J., Wiseman M. S., Hiller E. J., Shale D. J. Plasma tumour necrosis factor alpha in cystic fibrosis. Thorax. 1991 Feb;46(2):91–95. doi: 10.1136/thx.46.2.91. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Peterson M. B., Machaj V., Block P. C., Palacios I., Philbin D., Watkins W. D. Thromboxane release during percutaneous transluminal coronary angioplasty. Am Heart J. 1986 Jan;111(1):1–6. doi: 10.1016/0002-8703(86)90544-2. [DOI] [PubMed] [Google Scholar]
  20. Porayko M. K., Wiesner R. H., Hay J. E., Krom R. A., Dickson E. R., Beaver S., Schwerman L. Bone disease in liver transplant recipients: incidence, timing, and risk factors. Transplant Proc. 1991 Feb;23(1 Pt 2):1462–1465. [PubMed] [Google Scholar]
  21. Ross J., Gamble J., Schultz A., Lewiston N. Back pain and spinal deformity in cystic fibrosis. Am J Dis Child. 1987 Dec;141(12):1313–1316. [PubMed] [Google Scholar]
  22. Ross P. D., Davis J. W., Epstein R. S., Wasnich R. D. Pre-existing fractures and bone mass predict vertebral fracture incidence in women. Ann Intern Med. 1991 Jun 1;114(11):919–923. doi: 10.7326/0003-4819-114-11-919. [DOI] [PubMed] [Google Scholar]
  23. Smith D. D., Gowen M., Mundy G. R. Effects of interferon-gamma and other cytokines on collagen synthesis in fetal rat bone cultures. Endocrinology. 1987 Jun;120(6):2494–2499. doi: 10.1210/endo-120-6-2494. [DOI] [PubMed] [Google Scholar]
  24. Solomons N. W., Wagonfeld J. B., Rieger C., Jacob R. A., Bolt M., Horst J. V., Rothberg R., Sandstead H. Some biochemical indices of nutrition in treated cystic fibrosis patients. Am J Clin Nutr. 1981 Apr;34(4):462–474. doi: 10.1093/ajcn/34.4.462. [DOI] [PubMed] [Google Scholar]
  25. Taussig L. M., Kattwinkel J., Friedewald W. T., Di Sant'Agnese P. A. A new prognostic score and clinical evaluation system for cystic fibrosis. J Pediatr. 1973 Mar;82(3):380–390. doi: 10.1016/s0022-3476(73)80110-6. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES