title: The impact of dysglycaemia on bone mineral accrual in young people with cystic fibrosis.
abstract: OBJECTIVE
  The effect of dysglycaemia on bone mineral density (BMD) has not been studied in young people with CF. We examined factors associated with BMD in a tertiary paediatric CF clinic.
  
  
  METHODS
  Retrospective, clinic-based study at The Children's Hospital at Westmead, Sydney.
  
  
  METHODS
  Young people with CF aged ≤ 18 years.
  
  
  METHODS
  Bone mineral density was measured by dual-energy X-ray absorptiometry; main outcome measures were total body (TB), lumbar spine (LS) and femoral neck (FN) BMD and bone mineral content (BMC), and LS volumetric BMD (vBMD), reported as z scores for height. Dysglycaemia, based on oral glucose tolerance test, was defined as CF-related diabetes (CFRD) or impaired glucose tolerance (IGT).
  
  
  RESULTS
  Overall, 14 of 81 (17%) had CFRD, 6 (7%) IGT and 61 (76%) normal glucose tolerance (NGT). Mean age was 14.9 ± 2.4 years and mean height z score -0.68 ± 1.39. Osteopenic (z score ≤-2) TB, LS or FN BMD was present in 30 of 81 (37%), BMC in 42 (52%) and vBMD in 10 (5%). Across the three groups, there were differences in LS vBMD (CFRD, -0.67 ± 0.76; IGT, -0.52 ± 0.76; NGT, -0.05 ± 1.39; P = 0.04), LS BMD (P < 0.01), LS BMC (P = 0.01) and TB BMD (P = 0.01). In multivariate linear regression, LS BMC was associated with dysglycaemia (β = 0.56; 95% CI, 0.00-1.13; P = 0.05) and approached significance for FEV(1) (β = 0.01; 95% CI, 0.00-0.02; P = 0.06).
  
  
  CONCLUSIONS
  Dysglycaemia is associated with reduced bone mass accrual in youth with CF, in addition to recognized factors such as abnormal lung function, poor nutritional status and disease severity. Bone health assessment is essential in youth with CF.
authors: Institute of Endocrinology and Diabetes, Sydney Children's Hospital Network, Westmead, Australia.
authors: Malay
authors: M
authors: Rana
authors: Craig F
authors: CF
authors: Munns
authors: Hiran
authors: H
authors: Selvadurai
authors: Julie
authors: J
authors: Briody
authors: Maria E
authors: ME
authors: Craig
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D015519:Bone Density / Q000502:physiology*; D002648:Child; D003550:Cystic Fibrosis / Q000378:metabolism*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male