Bone mineral density in patients on home parenteral nutrition: a follow-up study.
OBJECTIVE
The variations of bone mineral density (BMD) during home parenteral nutrition (HPN) and their relationship with general, life style, primary disease and HPN risk factors were investigated by a follow-up study.


METHODS
Patients who had BMD assessment in a previous cross-sectional survey underwent a 2nd BMD at femoral neck (FN) and lumbar spine (LS). Data about risk factors were collected by a structured questionnaire. BMD Z-score (number of standard deviations from normal values corrected for sex and age) and the annualized percent BMD change were analysed.


RESULTS
Sixty-five adult patients were enrolled (follow-up: 18.1+/-5.5 months). The mean BMD Z-score significantly increased at the LS (P = 0.040) and remained unchanged at FN. In multiple regression analysis, the variations of the LS Z-score during HPN negatively correlated with the female sex (P = 0.021) and the age at starting HPN (P = 0.022). The analysis of the annualized percent BMD change confirmed the results obtained by the analysis of the Z-score. No factor was associated with BMD variation at FN.


CONCLUSIONS
HPN was not associated with a decrease of BMD in most of the patients; LS BMD Z-score variations were related to general risk factors rather than to HPN factors, showing a negative association with age and female sex.
Pironi
Loris
L
Department of Internal Medicine and Gastroenterology, St. Orsola Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy. loris.pironi@unibo.it
Tjellesen
Lone
L
De Francesco
Antonella
A
Pertkiewicz
Marek
M
Morselli Labate
A M Antonio M
AM
Staun
Michael
M
Przedlacki
Jerzy
J
Lezo
Antonella
A
Orlandoni
Paolo
P
Pasanisi
Francesco
F
D015502:Absorptiometry, Photon; D000328:Adult; D000367:Age Factors; D000368:Aged; D015519:Bone Density / Q000187:drug effects; D001847:Bone Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D016331:Parenteral Nutrition, Home / Q000009:adverse effects; D015995:Prevalence; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires