Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Bone Marrow Transplant. 2012 May;47(5):657-62. doi: 10.1038/bmt.2011.147. Epub 2011 Jul 18.
We measured bone mineral density (BMD) with dual-energy X-ray absorptiometry in the total body, at the lumbar spine, at the femoral neck and in the total hip, in 18 young adults with a median of 18.2 years after SCT. Fifteen patients had undergone auto-SCT and all patients had received TBI. The patients had significantly lower BMD in the total body, at the femoral neck, and in the total hip compared with age- and sex-matched controls. Six of 18 patients (33%) had low bone mass (z-score <-1) at one or more measurement sites, as opposed to two of the controls (11%, P=0.29). We found no significant influence of growth hormone levels or of untreated hypogonadism on BMD variables. Levels of 25-hydroxy (25(OH)) vitamin D were lower among the patients (35.2 vs 48.8 nmol/L, P=0.044) and were significantly correlated with total body BMD in the patient group (r=0.55, P=0.021). All six patients with low bone mass had hypovitaminosis D (≤37 nmol/L as opposed to 4 of the 11 (36%) patients without low bone mass (P=0.035). In conclusion, we found decreased BMD in SCT survivors, which may in part be caused by 25(OH) vitamin D deficiency.
我们使用双能 X 射线吸收法测量了 18 名 SCT 后中位数为 18.2 年的年轻成年人的全身、腰椎、股骨颈和全髋骨矿物质密度（BMD）。15 名患者接受了自体 SCT，所有患者均接受了 TBI。与年龄和性别匹配的对照组相比，患者的全身、股骨颈和全髋骨 BMD 显著降低。18 名患者中有 6 名（33%）在一个或多个测量部位存在低骨量（z 评分<-1），而对照组中只有 2 名（11%，P=0.29）。我们发现生长激素水平或未经治疗的性腺功能减退症对 BMD 变量没有显著影响。患者的 25-羟维生素 D（25(OH)D）水平较低（35.2 与 48.8 nmol/L，P=0.044），并且与患者组的全身 BMD 呈显著相关（r=0.55，P=0.021）。低骨量的 6 名患者均存在维生素 D 缺乏症（≤37 nmol/L，而无低骨量的 11 名患者中有 4 名（36%）患者存在维生素 D 缺乏症（P=0.035）。总之，我们发现 SCT 幸存者的 BMD 降低，这可能部分是由 25(OH)D 缺乏引起的。
