title: Evaluation of factors related to bone disease in Polish children and adolescents with cystic fibrosis.
abstract: OBJECTIVE
  The aim of the study was to evaluate factors related to bone formation and resorption in Polish children and adolescents with cystic fibrosis and to examine the effect of nutritional status, biochemical parameters and clinical status on bone mineral density.
  
  
  METHODS
  The study group consisted of 100 children and adolescents with cystic fibrosis with a mean age 13.4 years old. Anthropometric measurements, included body height, body mass and body mass index (BMI); bone mineral densitometry and biochemical testing were performed. Bone mineral density was measured using a dual-energy X-ray absorption densitometer. Biochemical tests included serum calcium, phosphorus, parathyroid hormone and vitamin D concentrations, as well as 24-h urine calcium and phosphorus excretion. Pulmonary function was evaluated using FEV1%, and clinical status was estimated using the Shwachman-Kulczycki score.
  
  
  RESULTS
  Standardized body height, body mass and BMI were significantly lower than in the reference population. Mean serum vitamin D concentration was decreased. Pulmonary disease was generally mild, with a mean FEV1% of 81%. Multivariate linear regression revealed that the only factors that had a significant effect on bone marrow density were BMI and FEV1%. There were no significant correlations between bone mineral density and the results of any of the biochemical tests performed.
  
  
  CONCLUSIONS
  Nutritional status and bone mineral density were significantly decreased in children and adolescents with cystic fibrosis. In spite of abnormalities in biochemical testing, the factors that were found to have the strongest effect on bone mineral density were standardized BMI and clinical status.
authors.affiliation: Cystic Fibrosis Centre, Institute of Mother and Child, Warsaw, Poland. Electronic address: dorota.sands@imid.med.pl.
authors.forename: Dorota
authors.initials: D
authors.lastname: Sands
authors.affiliation: Cystic Fibrosis Centre, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Mielus
authors.affiliation: Department of Human Biology, University of Wrocław, Poland.
authors.forename: Wioleta
authors.initials: W
authors.lastname: Umławska
authors.affiliation: Unit of Anthropology, Polish Academy of Sciences, Wrocław, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Lipowicz
authors.affiliation: Department of Gastroenterology, Hepatology and Feeding Disorders Children's Health Memorial Institute, Warsaw, Poland.
authors.forename: Beata
authors.initials: B
authors.lastname: Oralewska
authors.affiliation: Department of Pediatric Gastroenterology & Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland.
authors.forename: Jarosław
authors.initials: J
authors.lastname: Walkowiak
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D015519:Bone Density / Q000502:physiology; D001847:Bone Diseases / Q000097:blood* / Q000378:metabolism / Q000473:pathology*; D002648:Child; D003550:Cystic Fibrosis / Q000097:blood* / Q000378:metabolism / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D011044:Poland / Q000453:epidemiology; D014807:Vitamin D / Q000097:blood
chemical_list: D014807:Vitamin D
keywords: Adolescents; Bone mineral density; Cystic fibrosis; Nutritional status; Vitamin D