Bachrach L K, Loutit C W, Moss R B
Department of Pediatrics, Stanford University School of Medicine, California.
Am J Med. 1994 Jan;96(1):27-34. doi: 10.1016/0002-9343(94)90112-0.
To examine the frequency and severity of osteopenia in adults with cystic fibrosis and the clinical variables associated with reduced bone mineral.
The bone mineral status of 22 white adults (14 women) with cystic fibrosis was compared with normative data from healthy white control subjects in a university medical center. Lumbar spine, femoral neck, and whole-body bone mineral was determined by dual energy x-ray absorptiometry and expressed as bone mineral content (g), bone mineral density (g/cm2), and bone mineral apparent density (g/cm3). Bone mass was related to age, body mass, gonadal function, pulmonary status, and glucocorticoid exposure to identify variables associated with reduced bone mineral in cystic fibrosis.
Bone mineral in adults with cystic fibrosis was significantly below expected values for age and sex at all sites using all expressions of bone mass. The mean Z-score was -2.8 for the lumbar spine bone density, -2.5 for the femoral neck, and -2.0 for the whole body. Bone mineral apparent density (a term that minimizes the influence of bone dimensions) was also significantly reduced in patients at the lumbar spine (p < 0.0001) and femoral neck (p < 0.001 to p < 0.0001), indicating that the bone mineral deficit seen in adults with cystic fibrosis could not be attributed to differences in bone size. Age, weight, height, and body mass index were significantly correlated with bone mineral. Pulmonary status, glucocorticoid use, and gonadal function failed to predict bone mineral status.
Osteopenia and osteoporosis occur commonly in young adults with cystic fibrosis. Age and body mass are predictive of bone mineral, although the pathogenesis of this bone mineral deficit is likely multifactorial.
研究成年囊性纤维化患者骨质减少的发生率和严重程度，以及与骨矿物质减少相关的临床变量。
在一所大学医学中心，将22名成年白人囊性纤维化患者（14名女性）的骨矿物质状况与健康白人对照受试者的标准数据进行比较。采用双能X线吸收法测定腰椎、股骨颈和全身的骨矿物质，以骨矿物质含量（克）、骨矿物质密度（克/平方厘米）和骨矿物质表观密度（克/立方厘米）表示。将骨量与年龄、体重、性腺功能、肺部状况和糖皮质激素暴露情况相关联，以确定与囊性纤维化患者骨矿物质减少相关的变量。
使用所有骨量表达方式时，成年囊性纤维化患者所有部位的骨矿物质均显著低于年龄和性别的预期值。腰椎骨密度的平均Z值为-2.8，股骨颈为-2.5，全身为-2.0。腰椎（p < 0.0001）和股骨颈（p < 0.001至p < 0.0001）患者的骨矿物质表观密度（该术语可最大程度减少骨尺寸的影响）也显著降低，表明成年囊性纤维化患者出现骨矿物质缺乏并非归因于骨大小的差异。年龄、体重、身高和体重指数与骨矿物质显著相关。肺部状况、糖皮质激素使用和性腺功能无法预测骨矿物质状况。
骨质减少和骨质疏松在年轻成年囊性纤维化患者中普遍存在。年龄和体重可预测骨矿物质，尽管这种骨矿物质缺乏的发病机制可能是多因素的。
