Bone mineral density in children with non-cystic fibrosis bronchiectasis.
BACKGROUND
Bronchiectasis presents as a common sequela of several chronic pulmonary diseases. Bone mineral density (BMD) is generally decreased in children with cystic fibrosis (CF). Although children with non-CF bronchiectasis have similar risk factors for osteopenia/osteoporosis, data on BMD in this group of patients are lacking.


OBJECTIVE
To evaluate BMD in children with non-CF bronchiectasis.


METHODS
In this study, we evaluated BMD of the radius and tibia in 32 children (17 girls) with non-CF bronchiectasis and in 23 healthy controls matched for age, sex and pubertal stage by quantitative ultrasound (speed of sound). Daily calcium intake and pulmonary function tests and data about steroid use were noted.


RESULTS
Mean age was 12.5 +/- 4.6 years. Six children (18%) had moderate-to-severe lung disease (FEV(1) <60% predicted). All except 2 children (94%) were receiving inhaled steroids. There was no significant difference in BMD (expressed as z-score) of the radius and tibia between the patient and control groups (tibia z-scores: -0.1 +/- 0.9 vs. -0.8 +/- 0.8 and radius z-scores -1.3 +/- 1.4 vs. -1.0 +/- 0.9 in bronchiectasis patients and controls, respectively, p > 0.05). However, more children with non-CF bronchiectasis had osteopenia (z-scores between -1 and -2 SD) and osteoporosis (z-score <or=2 SD) compared to the control group (62 vs. 30%, p = 0.019). There was a significant correlation between age and radius z-scores (r = -0.365, p = 0.04). There was no correlation between BMD and severity of lung illness, calcium intake or cumulative steroid doses.


CONCLUSIONS
Osteopenia is more common in children with non-CF bronchiectasis compared to controls and the risk of osteoporosis and osteopenia increases with age.
Guran
Tulay
T
Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Marmara University, Istanbul, Turkey. tulayguran@yahoo.com
Turan
Serap
S
Karadag
Bulent
B
Ersu
Refika
R
Karakoc
Fazilet
F
Bereket
Abdullah
A
Dagli
Elif
E
D000293:Adolescent; D015519:Bone Density / Q000502:physiology*; D001987:Bronchiectasis / Q000150:complications / Q000378:metabolism*; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000209:etiology; D011884:Radius / Q000000981:diagnostic imaging; D013977:Tibia / Q000000981:diagnostic imaging; D014463:Ultrasonography