title: Bone mineral density, vitamin D, and nutritional status of children submitted to hematopoietic stem cell transplantation.
abstract: OBJECTIVE
  The aim of the study was to evaluate the effect of allogeneic hematopoietic stem cell transplantation (HSCT) on bone mineral density (BMD), serum vitamin D levels, and nutritional status of 50 patients between ages 4 and 20 y.
  
  
  METHODS
  We conducted pre-HSCT and 6-mo post-HSCT evaluations. We measured BMD at the lumbar spine (LS) and total body (TB) by dual energy x-ray absorptiometry (DXA); body composition by bioimpedance analysis, and dietary intakes of calcium and vitamin D using the 24-h recall and semiquantitative food frequency questionnaire methods.
  
  
  RESULTS
  We observed a significant reduction in BMD 6 mo post-HSCT. Nearly half (48%) of patients had reductions at the LS (average -9.6% ± 6.0%), and patients who developed graft-versus-host disease (GVHD) had the greatest reductions (-5.6% versus 1.2%, P < 0.01). We also found reductions in serum levels of 25-hydroxyvitamin D (25-OHD), from 25.6 ± 10.9 ng/dL to 20.4 ± 11.4 ng/dL (P < 0.05), and in body weight. Corticosteroid treatment duration, severity of chronic GVHD, serum 25-OHD levels, and family history of osteoporosis were all risk factors associated with variations in BMD at the LS.
  
  
  CONCLUSIONS
  HSCT in children and adolescents negatively effects their BMD, nutritional status, and vitamin D levels. We suggest that early routine assessment be done to permit prevention and treatment.
authors.affiliation: Bone Marrow Transplantation Unit, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil; Endocrine Division (SEMPR), Department of Internal Medicine, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil. Electronic address: Denisejca@gmai.com.
authors.forename: Denise Johnsson
authors.initials: DJ
authors.lastname: Campos
authors.affiliation: Endocrine Division (SEMPR), Department of Internal Medicine, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
authors.forename: César Luiz
authors.initials: CL
authors.lastname: Boguszewski
authors.affiliation: Bone Marrow Transplantation Unit, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
authors.forename: Vaneuza Araujo Moreira
authors.initials: VA
authors.lastname: Funke
authors.affiliation: Bone Marrow Transplantation Unit, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
authors.forename: Carmem Maria Sales
authors.initials: CM
authors.lastname: Bonfim
authors.affiliation: Endocrine Division (SEMPR), Department of Internal Medicine, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
authors.forename: Carolina Aguiar Moreira
authors.initials: CA
authors.lastname: Kulak
authors.affiliation: Bone Marrow Transplantation Unit, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pasquini
authors.affiliation: Endocrine Division (SEMPR), Department of Internal Medicine, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, Brazil.
authors.forename: Victória Zeghbi Cochenski
authors.initials: VZ
authors.lastname: Borba
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D001823:Body Composition; D015519:Bone Density / Q000187:drug effects*; D002136:Calcium, Dietary / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000378:metabolism; D008297:Male; D009752:Nutritional Status; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D014807:Vitamin D / Q000008:administration & dosage* / Q000097:blood*; D055815:Young Adult
chemical_list: D002136:Calcium, Dietary; D014807:Vitamin D
keywords: Bone marrow transplantation; Bone mineral density; Child nutrition; Nutritional status; Vitamin D