Bone mineral density and its contributing factors in Egyptian children with cystic fibrosis

Abstract

Abstract Background Cystic fibrosis (CF) is an autosomal recessive disorder that, despite advances in medical care, continues to be a life-limiting disease. With increase in life expectancy of the CF population, bone disease has emerged as a common complication. Aim The aim of the study was to determine bone mineral density (BMD) and total body composition (TBC) in a sample of Egyptian children with CF and assess the contributing factors that might be related to BMD deficits. Materials and methods This was a cross-sectional case–control study that included 15 children with CF who were of a mean age of 6.3±3.68 years (2.5–15 years) and were diagnosed by sweat chloride testing. All CF children were subjected to detailed history taking, thorough clinical examination, laboratory investigations, and pulmonary function tests. They also underwent growth, puberty, and nutrition evaluation. BMD and TBC were evaluated using dual-energy X-ray absorptiometry. Results CF children had significantly decreased mean BMD and TBC compared with the control group. An overall 26.66% of these patients had osteopenia and one patient was 3 years old. They also showed delayed growth when compared with Egyptian standards, and most of them (> 80%) presented with recurrent chest infections, malabsorption, undernutrition, and treatment with inhaled steroids for more than 6 months. Conclusion We demonstrated the presence of osteopenia in our CF patients that presented early in life. Improving nutritional status, correcting malabsorption, and limiting chest infections are necessary for prevention. Annual assessment of BMD and body composition should be initiated early in life to target those who need preventive treatment against osteoporosis and reduce the risk for fractures later in life.

Keywords

• body composition
• bone mineral density
• contributing factors
• cystic fibrosis