Hardin D S, Arumugam R, Seilheimer D K, LeBlanc A, Ellis K J
Department of Pediatrics, The Feigen Center, Suite 410, 6621 Fannin, Houston, TX 77030, USA.
Arch Dis Child. 2001 Apr;84(4):363-8. doi: 10.1136/adc.84.4.363.
Osteoporosis has been reported as a complication of cystic fibrosis (CF).
To measure bone mineral density (BMD) in non-acutely ill adults and bone mineral content (BMC) in children with CF.
We analysed data from 28 adults and 13 children with CF. Corticosteroid use was minimal for the year prior to study in both groups. Dual x ray absorptiometry was used to measure total body and regional bone mineral density in adults. In children, whole body BMC was measured. Lean tissue mass (LTM) was also measured in all subjects. There were two control groups: A (matched for LTM and height, in addition to age and gender); and B (matched for age and gender only).
There was no difference in whole body or regional BMD density between adult CF patients and control A subjects. Both whole body and regional BMD were significantly lower in adult CF patients than in control B subjects. Total body BMD was correlated with body mass index, LTM, and percent fat in both CF and control subjects. There was no significant correlation between total body BMD or regional BMD and either NIH clinical status scores, or pulmonary function tests in adults. There was no difference in total body BMC between CF children and control A subjects. Total body BMC was significantly lower in CF children than in control B subjects. There was no correlation between pulmonary function results and BMC in children.
Osteopenia and osteoporosis in CF may be caused more by malnutrition and chronic use of intravenous or oral corticosteroids than by a CF related inherent defect in BMD. Appropriate "normal" data should be selected when determining whether or not osteoporosis is present in a CF patient.
骨质疏松已被报道为囊性纤维化（CF）的一种并发症。
测量非急性病成年CF患者的骨密度（BMD）以及CF患儿的骨矿物质含量（BMC）。
我们分析了28例成年CF患者和13例CF患儿的数据。两组在研究前一年的皮质类固醇使用量均极少。采用双能X线吸收法测量成年患者的全身和局部骨密度。对于儿童，测量全身BMC。所有受试者还测量了瘦组织质量（LTM）。有两个对照组：A组（除年龄和性别外，还匹配LTM和身高）；B组（仅匹配年龄和性别）。
成年CF患者与对照组A受试者的全身或局部BMD密度无差异。成年CF患者的全身和局部BMD均显著低于对照组B受试者。CF患者和对照组受试者的全身BMD均与体重指数、LTM和体脂百分比相关。成年患者的全身BMD或局部BMD与NIH临床状态评分或肺功能测试之间均无显著相关性。CF患儿与对照组A受试者的全身BMC无差异。CF患儿的全身BMC显著低于对照组B受试者。儿童的肺功能结果与BMC之间无相关性。
CF患者的骨质减少和骨质疏松可能更多是由营养不良以及长期静脉或口服皮质类固醇引起的，而非CF相关的BMD固有缺陷。在确定CF患者是否存在骨质疏松时，应选择合适的“正常”数据。
