O'Brien Catherine E, Com Gulnur, Fowlkes John, Tang Xinyu, James Laura P
Department of Pharmacy Practice, University of Arkansas for Medical Sciences College of Pharmacy, Little Rock, Arkansas, United States of America.
Department of Pediatrics, University of Southern California, Keck School of Medicine, Los Angeles, California, United States of America.
PLoS One. 2018 Jan 11;13(1):e0191013. doi: 10.1371/journal.pone.0191013. eCollection 2018.
In 2015, 11.9% of people with cystic fibrosis (CF) in the United States had osteopenia, 5.1% osteoporosis, and 0.3% experienced a fracture. Screening for CF-related bone disease starts in childhood, and dual energy x-ray absorptiometry (DXA) is the recommended method. It is unknown whether peripheral quantitative computed tomography (pQCT) can detect deficits earlier than DXA. This study compared pQCT and DXA scans in a group of pre-pubertal children with CF and healthy controls.
This was a cross-sectional study of children at Tanner stage 1. A pQCT scan of the radius at proximal and distal sites was performed plus a total body DXA scan. Serum C-reactive protein, interleukin-6 and tumor necrosis factor-alpha were also measured.
A total of 34 subjects completed the study; 14 with CF and 20 controls. At the distal radius, pQCT showed a lower total bone mineral density (BMD) Z-score for the CF group (P = 0.01 and P = 0.03 for 2 different reference databases) compared to controls. At the proximal site, the polar strength-strain index was lower in the CF group (P = 0.017). Finally, the total body BMD Z-score by DXA was lower in the CF group, although it did not meet the definition of reduced bone density (P = 0.004). Biomarkers of inflammation were not different.
In this group of pre-pubertal children with CF, measures of bone strength and density by both pQCT and DXA were reduced compared to healthy controls.
2015年，美国11.9%的囊性纤维化（CF）患者患有骨质减少，5.1%患有骨质疏松症，0.3%曾发生骨折。CF相关骨病的筛查始于儿童期，双能X线吸收法（DXA）是推荐的方法。尚不清楚外周定量计算机断层扫描（pQCT）是否能比DXA更早检测到骨量不足。本研究比较了一组青春期前CF患儿和健康对照者的pQCT和DXA扫描结果。
这是一项针对坦纳1期儿童的横断面研究。对桡骨近端和远端进行pQCT扫描，并进行全身DXA扫描。还测量了血清C反应蛋白、白细胞介素-6和肿瘤坏死因子-α。
共有34名受试者完成了研究；14名CF患儿和20名对照者。在桡骨远端，与对照组相比，CF组的pQCT显示总骨矿物质密度（BMD）Z评分较低（对于2个不同的参考数据库，P=0.01和P=0.03）。在近端部位，CF组的极向强度应变指数较低（P=0.017）。最后，CF组通过DXA测得的全身BMD Z评分较低，尽管未达到骨密度降低的定义（P=0.004）。炎症生物标志物无差异。
在这组青春期前CF患儿中，与健康对照者相比，pQCT和DXA测得的骨强度和骨密度指标均降低。
