Guran Tulay, Turan Serap, Karadag Bulent, Ersu Refika, Karakoc Fazilet, Bereket Abdullah, Dagli Elif
Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Marmara University, Istanbul, Turkey.
Respiration. 2008;75(4):432-6. doi: 10.1159/000105386. Epub 2007 Jul 6.
Bronchiectasis presents as a common sequela of several chronic pulmonary diseases. Bone mineral density (BMD) is generally decreased in children with cystic fibrosis (CF). Although children with non-CF bronchiectasis have similar risk factors for osteopenia/osteoporosis, data on BMD in this group of patients are lacking.
To evaluate BMD in children with non-CF bronchiectasis.
In this study, we evaluated BMD of the radius and tibia in 32 children (17 girls) with non-CF bronchiectasis and in 23 healthy controls matched for age, sex and pubertal stage by quantitative ultrasound (speed of sound). Daily calcium intake and pulmonary function tests and data about steroid use were noted.
Mean age was 12.5 +/- 4.6 years. Six children (18%) had moderate-to-severe lung disease (FEV(1) <60% predicted). All except 2 children (94%) were receiving inhaled steroids. There was no significant difference in BMD (expressed as z-score) of the radius and tibia between the patient and control groups (tibia z-scores: -0.1 +/- 0.9 vs. -0.8 +/- 0.8 and radius z-scores -1.3 +/- 1.4 vs. -1.0 +/- 0.9 in bronchiectasis patients and controls, respectively, p > 0.05). However, more children with non-CF bronchiectasis had osteopenia (z-scores between -1 and -2 SD) and osteoporosis (z-score <or=2 SD) compared to the control group (62 vs. 30%, p = 0.019). There was a significant correlation between age and radius z-scores (r = -0.365, p = 0.04). There was no correlation between BMD and severity of lung illness, calcium intake or cumulative steroid doses.
Osteopenia is more common in children with non-CF bronchiectasis compared to controls and the risk of osteoporosis and osteopenia increases with age.
支气管扩张是几种慢性肺部疾病常见的后遗症。囊性纤维化（CF）患儿的骨矿物质密度（BMD）通常会降低。尽管非CF支气管扩张患儿发生骨质减少/骨质疏松的风险因素相似，但该组患者的BMD数据仍很缺乏。
评估非CF支气管扩张患儿的BMD。
在本研究中，我们通过定量超声（声速）评估了32例非CF支气管扩张患儿（17例女孩）及23例年龄、性别和青春期阶段相匹配的健康对照者的桡骨和胫骨BMD。记录每日钙摄入量、肺功能测试结果以及类固醇使用情况。
平均年龄为12.5±4.6岁。6例患儿（18%）患有中重度肺部疾病（FEV(1)<预测值的60%）。除2例患儿（94%）外，所有患儿均接受吸入性类固醇治疗。患者组和对照组桡骨和胫骨的BMD（以z评分表示）无显著差异（支气管扩张患儿和对照组的胫骨z评分分别为-0.1±0.9和-0.8±0.8，桡骨z评分分别为-1.3±1.4和-1.0±0.9，p>0.05）。然而，与对照组相比，非CF支气管扩张患儿中骨质减少（z评分在-1至-2 SD之间）和骨质疏松（z评分≤-2 SD）的患儿更多（分别为62%和30%，p=0.019）。年龄与桡骨z评分之间存在显著相关性（r=-0.365，p=0.04）。BMD与肺部疾病严重程度、钙摄入量或累积类固醇剂量之间无相关性。
与对照组相比，非CF支气管扩张患儿中骨质减少更为常见，且骨质疏松和骨质减少的风险随年龄增加。
