Sheikh Shahid, Gemma Susan, Patel Alpa
Division of Pulmonary Medicine, Department of Pediatrics, Nationwide Children's Hospital, ED 444 700 Children's Drive, Columbus, OH, 43205, USA,
J Bone Miner Metab. 2015 Mar;33(2):180-5. doi: 10.1007/s00774-014-0572-z. Epub 2014 Mar 16.
Osteoporosis associated with cystic fibrosis is becoming more important as the life expectancy of patients continues to improve. This study was done to determine the prevalence of osteoporosis and osteopenia in CF patients and to identify risk factors. We reviewed the medical charts of 103 adults and adolescents with Cystic Fibrosis who had undergone a dual energy X-ray absorptiometry (DEXA) scan to measure the bone mineral content of the lumbar spine (L1-L4). Disease severity was assessed by lung function and body mass index (BMI) was calculated from weight and height at the time of the DEXA. None of the patients were being treated for low BMD. Random blood samples were analyzed for biochemical markers. The relationship between all these variables and BMD measurements was analyzed. Of 103 patients, ten (9.7%) patients (9 males, 1 female) were diagnosed with osteoporosis. An additional 36 (35%) patients (26 males, 10 females) were identified as having osteopenia. BMI, gender, weight, lung functions (FVC, FEV1, and FEF 25-75), and alkaline phosphatase, and 25-OH vitamin D levels were significantly correlated with Z-scores (p < 0.05). Stepwise linear regression revealed that a low Z-score was best predicted with low FEV1, male gender, low weight, and low 25-OH vitamin D levels (p < 0.05) for each variable. Osteopenia and osteoporosis are common in adults with CF, especially in male patients and in patients with low lung function, body weight, and 25-OH vitamin D levels.
随着囊性纤维化患者预期寿命的不断提高，与之相关的骨质疏松症问题日益凸显。本研究旨在确定囊性纤维化患者中骨质疏松症和骨质减少症的患病率，并找出风险因素。我们回顾了103例接受双能X线吸收测定法（DEXA）扫描以测量腰椎（L1-L4）骨矿物质含量的成年和青少年囊性纤维化患者的病历。通过肺功能评估疾病严重程度，并根据DEXA检查时的体重和身高计算体重指数（BMI）。所有患者均未接受低骨密度治疗。采集随机血样分析生化指标。分析了所有这些变量与骨密度测量值之间的关系。103例患者中，10例（9.7%）（9例男性，1例女性）被诊断为骨质疏松症。另有36例（35%）患者（26例男性，10例女性）被确定为骨质减少。BMI、性别、体重、肺功能（FVC、FEV1和FEF 25-75）、碱性磷酸酶以及25-羟基维生素D水平与Z值显著相关（p<0.05）。逐步线性回归显示，低FEV1、男性、低体重和低25-羟基维生素D水平对低Z值的预测效果最佳（每个变量p<0.05）。骨质减少和骨质疏松在成年囊性纤维化患者中很常见，尤其是男性患者以及肺功能、体重和25-羟基维生素D水平较低的患者。
