Ciuca Ioana M, Pop Liviu L, Rogobete Alexandru F, Onet Dan I, Guta-Almajan Bogdan, Popa Zoran, Horhat Florin G
Clin Lab. 2016 Sep 1;62(9):1725-1730. doi: 10.7754/Clin.Lab.2016.160141.
Cystic fibrosis (CF) is the most frequent monogenic genetic disease with autosomal recessive transmission and characterized by important clinical polymorphism and significant lethal prospective. CF related bone disease occurs frequently in adults with CF. Childhood is the period of bone formation, and therefore, children are more susceptible to low bone density. Several factors like pancreatic insufficiency, hormone imbalance, and physical inactivity contribute to CF bone disease development. Revealing this would be important for prophylactic treatment against bone disease occurrence. The study was observational, transversal, with a cross-sectional design.
The study included 68 children with cystic fibrosis, genotyped and monitored in the National CF Centre. At the annual assessment, besides clinical examination, biochemical evaluation for pancreatic insufficiency, and diabetes, they were evaluated for bone mineral density using dual energy X-ray absorptiometry (DXA).
Twenty-six patients, aged over 10 years were diagnosed with CF bone disease, without significant gender gap. Bone disease was frequent in patients aged over 10 years with exocrine pancreatic insufficiency, carriers of severe mutations, and CF liver disease.
CF carriers of a severe genotype which associates pancreatic insufficiency and CF liver disease, are more likely predisposed to low bone mineral density. Further studies should discover other significant influences in order to prevent the development of CF bone disease and an improved quality of life in cystic fibrosis children.
囊性纤维化(CF)是最常见的常染色体隐性遗传单基因疾病,具有重要的临床多态性和较高的致死率。CF相关骨病在成年CF患者中很常见。儿童期是骨骼形成期,因此儿童更容易出现低骨密度。胰腺功能不全、激素失衡和缺乏运动等多种因素导致CF骨病的发生。了解这些因素对于预防骨病的发生具有重要意义。本研究为观察性横断面研究。
该研究纳入了68名在国家CF中心进行基因分型和监测的囊性纤维化儿童。在年度评估中,除了临床检查、胰腺功能不全和糖尿病的生化评估外,还使用双能X线吸收法(DXA)对他们的骨密度进行评估。
26名年龄超过10岁的患者被诊断为CF骨病,无明显性别差异。骨病在年龄超过10岁、患有外分泌性胰腺功能不全、携带严重突变以及患有CF肝病的患者中较为常见。
携带与胰腺功能不全和CF肝病相关的严重基因型的CF患者,更易出现低骨密度。进一步的研究应发现其他重要影响因素,以预防CF骨病的发展并改善囊性纤维化儿童的生活质量。