Department of Medicine, University of Iowa, Iowa City, Iowa, USA.
Department of Pediatrics, University of Iowa, Iowa City, Iowa, USA.
Muscle Nerve. 2019 Apr;59(4):422-425. doi: 10.1002/mus.26413. Epub 2019 Jan 24.
Patients with Duchenne muscular dystrophy (DMD) exhibit low bone mineral density and increased fracture risk. Because glucocorticoid therapy results in delayed puberty and short stature, it is important to account for delayed skeletal development when interpreting patients' bone mineral density.
Twelve glucocorticoid-treated patients with DMD were evaluated by dual x-ray absorptiometry scans and wrist x-rays to estimate bone density and bone age, respectively. Z-scores were determined on the basis of chronological age. Each patient was assigned a "corrected" birth date that was calculated according to bone age, and a bone-age-corrected z-score was determined.
Z-scores adjusted for chronological age were lower than those adjusted for bone age.
We suggest the use of bone age as an alternative to chronological age for analysis of bone mineral density in glucocorticoid-treated patients with DMD. Additional research is required to determine the optimal method to predict fracture risk in this patient group. Muscle Nerve 59:422-425, 2019.
杜氏肌营养不良症(DMD)患者的骨密度较低,骨折风险增加。由于糖皮质激素治疗会导致青春期延迟和身材矮小,因此在解释患者的骨密度时,重要的是要考虑到骨骼发育的延迟。
通过双能 X 线吸收仪扫描和腕骨 X 射线对 12 名接受糖皮质激素治疗的 DMD 患者进行评估,分别用于估计骨密度和骨龄。基于实际年龄确定 Z 分数。根据骨龄为每个患者分配了一个“校正”出生日期,并确定了骨龄校正后的 Z 分数。
根据实际年龄校正的 Z 分数低于根据骨龄校正的 Z 分数。
我们建议使用骨龄代替实际年龄来分析接受糖皮质激素治疗的 DMD 患者的骨矿物质密度。需要进一步的研究来确定预测该患者群体骨折风险的最佳方法。肌肉神经 59:422-425, 2019.