scholarly journals Bone Mineral Density in Cystic Fibrosis Patients with the CFTR I1234V Mutation in a Large Kindred Family Is Associated with Pancreatic Sufficiency

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Atqah Abdul Wahab ◽  
M. Hammoudeh ◽  
Mona Allangawi ◽  
Fawziya Al-Khalaf ◽  
Prem Chandra

Objectives. To study bone mineral density (BMD) in cystic fibrosis (CF) children and adults with the CFTR I1234V mutation associated with pancreatic sufficiency.Methods. Lumbar spine, total hip, and whole-body mineral density were measured by dual-energy radiographic absorptiometry (DEXA) scan.Zscore was used for those less than 21 years andTscore was used for those 21 years or older.Results. Twenty-one CF patients were younger than 21 years and 5 CF patients were 21 years or older. Mean age was 17.29 ± 4.95 years, ranging from 10 to 33 years. The mean BMDZscores for patients younger than 21 years were −0.69 ± 0.96 (lumbar spine = L1–L4), −0.48 ± 0.92 (total hip), and −0.38 ± 0.86 (total body). The meanTscores for patients 21 years or older were 0.14 ± 0.7 (L1–L4), 0.38 ± 1 (total hip), and 0.52 ± 1.03 (total body). BMD reduction less than −1 was found in 7 (26.9%) CF patients. Vitamin D deficiency in 20 CF patients (76.9%) tended to be lower in CF patients with low BMD. BMD was significantly correlated with FEV1; however, no significant association was observed withP. aeruginosacolonization.Conclusion. BMD reduction does occur in patients with mild CFTR mutation associated with pancreatic sufficiency.

2020 ◽  
Vol 105 (5) ◽  
pp. 1435-1444 ◽  
Author(s):  
Houchen Lyu ◽  
Sizheng S Zhao ◽  
Kazuki Yoshida ◽  
Sara K Tedeschi ◽  
Chang Xu ◽  
...  

Abstract Context Discontinuation of denosumab leads to a rapid reversal of its therapeutic effect. However, there are no data regarding how unintended delays or missed injections of denosumab impact bone mineral density (BMD) response. Objective We examined the association of delays in injections of denosumab with BMD change. Design We used electronic medical records from two academic hospitals from 2010 to 2017. Participants Patients older than 45 years of age and used at least 2 doses of 60 mg denosumab. Denosumab adherence was evaluated by the medication coverage ratio (MCR). Good adherence corresponds to a dosing interval ≤7 months (defined by MCR ≥93%), moderate adherence corresponds to an interval of 7 to 10 months (MCR 75%–93%), and poor adherence corresponds to an interval ≥10 months (MCR ≤75%). Outcome Measures Annualized percent BMD change from baseline at the lumbar spine, total hip, and femoral neck. Results We identified 938 denosumab injections among 151 patients; the mean (SD) age was 69 (10) years, and 95% were female. Patients with good adherence had an annualized BMD increase of 3.9% at the lumbar spine, compared with patients with moderate (3.0%) or poor adherence (1.4%, P for trend .002). Patients with good adherence had an annualized BMD increase of 2.1% at the total hip, compared with patients with moderate (1.3%) or poor adherence (0.6%, P for trend .002). Conclusions A longer interval between denosumab injections is associated with suboptimal BMD response at both spine and total hip. Strategies to improve the timely administration of denosumab in real-world settings are needed.


PEDIATRICS ◽  
1993 ◽  
Vol 91 (6) ◽  
pp. 1127-1130
Author(s):  
Antero Kotaniemi ◽  
Anneli Savolainen ◽  
Hannu Kautiainen ◽  
Heikki Kröger

Study objective. To investigate the degree and determinants of osteopenia in juvenile chronic polyarthritis. Design. Retrospective case-control study of central bone mineral density. Setting. Rheumatism Foundation Hospital and Kuopio University Hospital, Finland. Subjects. A sample of 43 girls aged 7 to 19 with juvenile chronic polyarthritis treated with systemic glucocorticoids and a control sample of 44 healthy girls matched for age. Main outcome measures. Bone mineral density and bone size (width) measured by dual-energy x-ray absorptiometry and bone volumetric density calculated as an approximation of true bone density at both the lumbar spine and femoral neck. Results. The girls with juvenile chronic arthritis had reduced bone mineral density, bone size, and bone volumetric density at both the lumbar spine and femoral neck (statistically significant findings, P = .022 for the bone size of the femoral neck and P < .001 for the other parameters). At the spine, the mean bone mineral density was 80%, the mean bone size 89%, and the mean bone volumetric density 89% of the values in the control group. At the femoral neck, the values were 78%, 93%, and 83%, respectively. The groups were matched for age, but the girls with arthritis were smaller and lighter. In the juvenile arthritis group, the femoral bone mineral density and bone volumetric density and the spinal bone width correlated negatively with the mean glucocorticoid dose. Conclusion. Axial bone mineral density is clearly reduced in severe juvenile polyarthritis and is mediated by both decreased bone volumetric density and diminished growth.


Author(s):  
Luke Del Vecchio ◽  
Nattai Borges ◽  
Campbell MacGregor ◽  
Jarrod D. Meerkin ◽  
Mike Climstein

Background: Previous research highlighted positive musculoskeletal adaptations resulting from mechanical forces and loadings distinctive to impacts and movements with sports participation. However, little is known about these adaptations in combat athletes. The aim of this study was to quantify bone mineral density, lean muscle mass and punching and kicking power in amateur male combat athletes. Methods: Thirteen male combat athletes (lightweight and middleweight) volunteered all physiological tests including dual energy X-ray absorptiometry for bone mineral density (BMD) segmental body composition (lean muscle mass, LMM), muscle strength and striking power, sedentary controls (n = 15) were used for selected DXA outcome variables. Results: There were significant differences (p < 0.05) between combat groups for lumbar spine (+5.0%), dominant arm (+4.4%) BMD, and dominant and non-dominant leg LMM (+21.8% and +22.6%). Controls had significantly (p < 0.05) high adiposity (+36.8% relative), visceral adipose tissue (VAT) mass (+69.7%), VAT area (+69.5%), lower total body BMD (−8.4%) and lumbar spine BMD (−13.8%) than controls. No differences in lower limb BMD were seen in combat groups. Arm lean mass differences (dominant versus non-dominant) were significantly different between combat groups (p < 0.05, 4.2% versus 7.3%). There were no differences in punch/kick power (absolute or relative) between combat groups. 5RM strength (bench and squat) correlated significantly with upper limb striking power (r = 0.57), dominant and non-dominant leg BMD (r = 0.67, r = 0.70, respectively) and total body BMD (r = 0.59). Conclusion: BMD and LMM appear to be particularly important to discriminate between dominant and non-dominant upper limbs and less so for lower limb dominance in recreational combat athletes.


2009 ◽  
Vol 127 (5) ◽  
pp. 278-282 ◽  
Author(s):  
Maria Eugênia Farias Almeida Motta ◽  
Maria Eduarda Nóbrega de Faria ◽  
Gisélia Alves Pontes da Silva

CONTEXT AND OBJECTIVE: Low bone mineral density may be a finding among children and adolescents with celiac disease, including those undergoing treatment with a gluten-free diet, but the data are contradictory. The aim of this study was to determine the frequency of bone mineral density abnormalities in patients on a gluten-free diet, considering age at diagnosis and duration of dietary treatment. DESIGN AND SETTING: Cross-sectional prevalence study at the Pediatric Gastroenterology Outpatient Clinic of Instituto Materno Infantil Professor Fernando Figueira. METHODS: Thirty-one patients over five years of age with celiac disease and on a gluten-free diet were enrolled. Bone mineral density (in g/cm²) was measured in the lumbar spine and whole body using bone densitometry and categorized using the criteria of the International Society for Clinical Densitometry, i.e. low bone mineral density for chronological age < -2.0 Z-scores. Age at diagnosis and duration of dietary treatment were confirmed according to the date of starting the gluten-free diet. RESULTS: Low bone density for chronological age was present in 3/31 patients in the lumbar spine and 1/31 in the whole body (also with lumbar spine abnormality). At diagnosis, three patients with low bone mineral density for the chronological age were more than 7.6 years old. These patients had been on a gluten-free diet for six and seven months and 3.4 years. CONCLUSION: Pediatric patients with celiac disease on long-term treatment are at risk of low bone mineral density. Early diagnosis and long periods of gluten-free diet are directly implicated in bone density normalization.


Author(s):  
Sharad Deshmukh ◽  
Suchita Deshmukh ◽  
Sarojni A Parameswran ◽  
P Pirmanayagam ◽  
N Murgan ◽  
...  

Background: Abnormalities in the bone metabolism observed in chronic liver disease are referred to as hepatic osteodystrophy. Osteoporosis and osteopenia are each part of this condition. Both conditions have a significant impact on morbidity, causing fractures that may result in chronic pain, long-lasting immobility, and deformity. Prevalence of fracture in patients with liver transplantation ranges from 15% - 65%. A high rate of fracturing is seen within the initial 1–2 years after transplantation. Aim: To determine the prevalence of low bone mineral density (osteopenia and osteoporosis) in Indian patients with cirrhosis of liver awaiting liver transplantation as per currently used Hologic DXA database Methods: This was a prospective observational study done at the department of gastroenterology and hepatology, Apollo Hospitals, Chennai from April 2011 to March 2013. All patients who fulfilled the inclusion criteria underwent detailed history taking, physical examination and relevant laboratory investigations. One hundred patients were selected for the scope of the study. Results: Sixty-eight per cent of patients were in the age group of 45 to 65 years. The mean age ± SD of the study subjects was 51.2 ± 9.7 years. The mean age for male patients was 50.5 ± 10.1 years, and for females was 54 ± 7.3 years. Cirrhosis was due to alcohol in 36% of the patients, viral hepatitis in 28% (HBV in 10% and HCV in 18%) patients. 42% were in Child’s class B, and the remaining 58% were in Child’s class C. MELD score was less than 20 in 62% patients. One third was diabetic; one third gave the history of backache. History of smoking was present in one fifth (20%) patients, and a history of fracture (most of them were traumatic) was present in 13% of patients. By using Hologic DXA database at the lumbar spine, osteopenia and osteoporosis were diagnosed in 44% and 38 % patients respectively. At the femoral neck, osteopenia and osteoporosis were diagnosed in 45% and 9% of patients. By using ICMR database at the lumbar spine, osteopenia and osteoporosis were diagnosed in 38% and 17% patients respectively. Similarly, at the femoral neck, osteopenia and osteoporosis were diagnosed in 34% and 5%. By using the Hologic DXA database, osteopenia and osteoporosis were diagnosed in 42% and 40 % patients. By using ICMR database, osteopenia and osteoporosis were diagnosed in 43% and 19% patients respectively. Conclusion: In light of the above results, the present study revealed a high prevalence of low bone mineral density (osteopenia and osteoporosis) in Indian patients with cirrhosis of liver awaiting liver transplantation. The lumbar spine was the most frequently and severely affected site in hepatic osteodystrophy. Keywords: Osteopenia, Osteoporosis, Low Bone Mineral Density, Liver Cirrhosis


2020 ◽  
Vol 14 ◽  
pp. 175346662096514
Author(s):  
Francois Maltais ◽  
Isabelle Schenkenberger ◽  
Pascal L. M. L. Wielders ◽  
Juan Ortiz de Saracho ◽  
Kenneth Chinsky ◽  
...  

Background: The relationship between inhaled corticosteroids and bone mineral density (BMD) remains uncertain despite extensive research. Methods: This was an international, multicenter, randomized, double-blind, parallel-group, 3-year noninferiority study. Patients with chronic obstructive pulmonary disease (COPD) (⩾40 years of age; smoking history ⩾10 pack years) and at least one native hip evaluable for BMD were enrolled and randomized 1:1, stratified by sex, to treatment with vilanterol (VI) 25 µg or fluticasone furoate/vilanterol (FF/VI) 100 µg/25 µg. BMD measurements were taken via dual-energy X-ray absorptiometry every 6 months. The primary endpoint was assessment of the noninferiority of change from baseline in total hip BMD per year at the −1% noninferiority level. Change from baseline in BMD at the lumbar spine and BMD measurements by sex were secondary endpoints. Incidences of COPD exacerbations and bone fractures throughout the study were also recorded. Results: Of 283 randomized patients, 170 (60%) completed the study. Noninferiority was demonstrated for FF/VI versus VI with regards to change from baseline in total hip BMD per year, with changes of −0.27% and 0.18%, respectively, and a treatment difference of −0.46% per year [95% confidence interval (CI) −0.97 to 0.06]. The treatment difference for FF/VI versus VI regarding lumbar spine BMD was −0.51% per year (95% CI −1.11 to 0.10). COPD exacerbations and bone fracture rates were similar between treatment groups. Conclusion: FF/VI showed noninferiority to VI for change from baseline in total hip BMD per year, when assessed at the −1% noninferiority margin in a combined sample of men and women with COPD. The reviews of this paper are available via the supplemental material section.


Rheumatology ◽  
2009 ◽  
Vol 49 (3) ◽  
pp. 513-519 ◽  
Author(s):  
S. P. Desai ◽  
E. M. Gravallese ◽  
N. A. Shadick ◽  
R. Glass ◽  
J. Cui ◽  
...  

2012 ◽  
Vol 37 (5) ◽  
pp. 947-954 ◽  
Author(s):  
Sarah M. Camhi ◽  
Peter T. Katzmarzyk

Physical activity (PA), total body fat (TBF), and lean body mass (LBM) are associated with bone mineral density (BMD). However, the independent influence of PA on BMD, while controlling for body composition is not understood as well and is the purpose of the current study. Whole-body BMD (g·cm–2), femoral neck BMD (g·cm–2), TBF (kg), and LBM (kg) were measured with dual-energy X-ray absorptiometry. PA levels (total, work, sport, non-sport) were estimated using the Baecke questionnaire. General linear models determined the independent effects of PA on BMD (whole-body and femoral neck), with adjustment for age, sex, ethnicity, smoking, menopausal status (as appropriate), LBM, and TBF. These associations were also examined by sex and age group (20–34, 35–49, and 50–64 years). The sample included 802 adults (65% women; 13% African American) from the Pennington Center Longitudinal Study that were 20 to 64 years of age (mean ± SD: 46.9 ± 11.0 years). Higher sports scores were associated with higher femoral neck BMD in the total group, men and women, and in 20- to 34-year-olds and 35- to 49-year-olds, but not significant in those 50–64 years of age. Similar significant associations were found for sports score with total body BMD; however, this relationship was not significant for women or for those 50–64 years of age. Total PA had inconsistent relationships with both femoral neck BMD and total body BMD. Higher levels of sport-related PA are associated with higher femoral neck BMD; however, these relationships vary by PA domain and site of BMD measurement.


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