Melissa S Putman1, Joshua F Baker2, Ahmet Uluer3, Karen Herlyn4, Allen Lapey5, Leonard Sicilian6, Angela Pizzo Tillotson7, Catherine M Gordon8, Peter A Merkel2, Joel S Finkelstein9. 1. Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States; Division of Endocrinology, Boston Children's Hospital, Boston, MA, United States. Electronic address: msputman@partners.org. 2. Division of Rheumatology, University of Pennsylvania, Philadelphia, PA, United States. 3. Division of Respiratory Diseases, Boston Children's Hospital, Boston, MA, United States. 4. Poliklinik fuer Rheumatologie, University Hospital Schleswig-Holstein, Campus Luebeck, Germany. 5. Pulmonary Division, Department of Pediatrics, Massachusetts General Hospital, Boston, MA, United States. 6. Pulmonary Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States. 7. Mattina R. Proctor Diabetes Center, Mercy Hospital, Portland,ME, United States. 8. Division of Endocrinology, Boston Children's Hospital, Boston, MA, United States; Divisions of Adolescent Medicine and Endocrinology, Hasbro Children's Hospital, Providence, RI, United States. 9. Endocrine Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States.
Abstract
BACKGROUND: Improvements in clinical care have led to increased life expectancy in patients with cystic fibrosis (CF) over the past several decades. Whether these improvements have had significant effects on bone health in patients with CF is unclear. METHODS: This is a cross-sectional study comparing clinical characteristics and bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DXA) in adults with CF evaluated in 1995-1999 to age-, race-, and gender-matched patients with CF evaluated in 2011-2013 at the same center on calibrated DXA machines. RESULTS: The cohorts were similar in terms of age, BMI, pancreatic insufficiency, presence of F508del mutation, and reproductive history. In the most recent cohort, pulmonary function was superior, and fewer patients had vitamin D deficiency or secondary hyperparathyroidism. Areal BMD measures of the PA spine, lateral spine, and distal radius were similarly low in the two cohorts. CONCLUSIONS: Although pulmonary function and vitamin D status were better in patients in the present-day cohort, areal BMD of the spine was reduced in a significant number of patients and was no different in patients with CF today than in the late 1990s. Further attention to optimizing bone health may be necessary to prevent CF-related bone disease.
BACKGROUND: Improvements in clinical care have led to increased life expectancy in patients with cystic fibrosis (CF) over the past several decades. Whether these improvements have had significant effects on bone health in patients with CF is unclear. METHODS: This is a cross-sectional study comparing clinical characteristics and bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DXA) in adults with CF evaluated in 1995-1999 to age-, race-, and gender-matched patients with CF evaluated in 2011-2013 at the same center on calibrated DXA machines. RESULTS: The cohorts were similar in terms of age, BMI, pancreatic insufficiency, presence of F508del mutation, and reproductive history. In the most recent cohort, pulmonary function was superior, and fewer patients had vitamin Ddeficiency or secondary hyperparathyroidism. Areal BMD measures of the PA spine, lateral spine, and distal radius were similarly low in the two cohorts. CONCLUSIONS: Although pulmonary function and vitamin D status were better in patients in the present-day cohort, areal BMD of the spine was reduced in a significant number of patients and was no different in patients with CF today than in the late 1990s. Further attention to optimizing bone health may be necessary to prevent CF-related bone disease.
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