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Bone mineral density, lung function, vitamin D and body composition in children and adolescents with cystic fibrosis: a multicenter study.
Nutr Hosp 2018; 35(4):789-795NH

Abstract

BACKGROUND

cystic fibrosis (CF) is the most common inherited disease in Caucasian population. Nowadays, long survival has led to the emergence of new complications, such as CF bone disease (CFBD), which is characterized by increased fracture risk.

OBJECTIVES

evaluate the association of bone mineral density (BMD) with lung function and BMD with 25-hydroxivitamin D (25OHD) plasmatic levels in children/adolescents with CF.

METHODS

we conducted a multicenter, cross-sectional study with clinically stable CF patients between five and 18 years. Weight, height, pubertal development, BMD and body composition (DXA), pulmonary function (FEV1 and FEF25-75) and 25OHD plasmatic levels were measured. Patients answered food intake and physical activity surveys. p values under 0.05 were considered as statistically significant.

RESULTS

thirty-seven patients were enrolled, 51% with normal respiratory function. Mean BMD Z-score in lumbar spine and in total body less head were -0.4 and -0.5 respectively. Twenty seven percent had a fat free mass index below the third percentile, 89% had 25OHD levels lower than 30 ng/ml and 78.4% had a low calcium intake. We did not find any correlations between BMD Z-scores, lung function or 25OHD levels. Patients with fat free mass (FFM) below the third percentile had BMD Z-score lower than -1 more frequently, in both locations (p < 0.006 and p < 0.001, respectively).

CONCLUSIONS

although most assessed patients had normal BMD and normal lung function, a high proportion had low: FFM, calcium intake and 25OHD levels. The association between low FFM and low BMD highlights the importance of improving body composition in CF patients, in order to prevent future CFBD.

Authors+Show Affiliations

. paulinabravo1961@gmail.com.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

30070865

Citation

Bravo M, Paulina, et al. "Bone Mineral Density, Lung Function, Vitamin D and Body Composition in Children and Adolescents With Cystic Fibrosis: a Multicenter Study." Nutricion Hospitalaria, vol. 35, no. 4, 2018, pp. 789-795.
Bravo M P, Balboa P, Torrejón C, et al. Bone mineral density, lung function, vitamin D and body composition in children and adolescents with cystic fibrosis: a multicenter study. Nutr Hosp. 2018;35(4):789-795.
Bravo M, P., Balboa, P., Torrejón, C., Bozzo, R., Boza, M. L., Contreras, I., ... Weisstaub, G. (2018). Bone mineral density, lung function, vitamin D and body composition in children and adolescents with cystic fibrosis: a multicenter study. Nutricion Hospitalaria, 35(4), pp. 789-795. doi:10.20960/nh.1609.
Bravo M P, et al. Bone Mineral Density, Lung Function, Vitamin D and Body Composition in Children and Adolescents With Cystic Fibrosis: a Multicenter Study. Nutr Hosp. 2018 Jun 28;35(4):789-795. PubMed PMID: 30070865.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Bone mineral density, lung function, vitamin D and body composition in children and adolescents with cystic fibrosis: a multicenter study. AU - Bravo M,Paulina, AU - Balboa,Paulina, AU - Torrejón,Claudia, AU - Bozzo,Rodrigo, AU - Boza,María Lina, AU - Contreras,Ilse, AU - Jorquera,Pablo, AU - Astorga,Luis, AU - Weisstaub,Gerardo, Y1 - 2018/06/28/ PY - 2017/10/04/received PY - 2018/04/15/accepted PY - 2018/04/11/revised PY - 2018/8/3/entrez PY - 2018/8/3/pubmed PY - 2018/11/28/medline SP - 789 EP - 795 JF - Nutricion hospitalaria JO - Nutr Hosp VL - 35 IS - 4 N2 - BACKGROUND: cystic fibrosis (CF) is the most common inherited disease in Caucasian population. Nowadays, long survival has led to the emergence of new complications, such as CF bone disease (CFBD), which is characterized by increased fracture risk. OBJECTIVES: evaluate the association of bone mineral density (BMD) with lung function and BMD with 25-hydroxivitamin D (25OHD) plasmatic levels in children/adolescents with CF. METHODS: we conducted a multicenter, cross-sectional study with clinically stable CF patients between five and 18 years. Weight, height, pubertal development, BMD and body composition (DXA), pulmonary function (FEV1 and FEF25-75) and 25OHD plasmatic levels were measured. Patients answered food intake and physical activity surveys. p values under 0.05 were considered as statistically significant. RESULTS: thirty-seven patients were enrolled, 51% with normal respiratory function. Mean BMD Z-score in lumbar spine and in total body less head were -0.4 and -0.5 respectively. Twenty seven percent had a fat free mass index below the third percentile, 89% had 25OHD levels lower than 30 ng/ml and 78.4% had a low calcium intake. We did not find any correlations between BMD Z-scores, lung function or 25OHD levels. Patients with fat free mass (FFM) below the third percentile had BMD Z-score lower than -1 more frequently, in both locations (p < 0.006 and p < 0.001, respectively). CONCLUSIONS: although most assessed patients had normal BMD and normal lung function, a high proportion had low: FFM, calcium intake and 25OHD levels. The association between low FFM and low BMD highlights the importance of improving body composition in CF patients, in order to prevent future CFBD. SN - 1699-5198 UR - https://www.unboundmedicine.com/medline/citation/30070865/Bone_mineral_density_lung_function_vitamin_D_and_body_composition_in_children_and_adolescents_with_cystic_fibrosis:_a_multicenter_study_ L2 - http://revista.nutricionhospitalaria.net/index.php/nh/article/view/1609 DB - PRIME DP - Unbound Medicine ER -