title: Longitudinal Bone Mineralization Assessment in Children Treated With Long-Term Parenteral Nutrition for Severe Intestinal Failure.
abstract: BACKGROUND
  Metabolic bone disease is common in children receiving home parenteral nutrition (HPN) for intestinal failure (IF). Long-term evolution of bone mass in pediatric IF is poorly documented. The aims of this study were (1) to determine the prevalence of low bone mass (LBM) in children receiving HPN for IF, (2) to evaluate the evolution of total bone mineral content (TBMC) during HPN with dual-energy x-ray absorptiometry (DXA), and (3) to identify related factors.
  
  
  METHODS
  All children referred in our HPN center from 2004 to 2014 were eligible. Inclusion criteria were HPN dependence due to noninflammatory IF, at least 2 TBMC assessments, and HPN duration of at least 2 years at last DXA. TBMC was expressed in z score for ideal weight for height (WFH). LBM was defined by a TBMC WFH z score ≤-2 standard deviations (SD).
  
  
  RESULTS
  A total of 175 DXAs for 31 children were performed, mean of 5.6 ± 2.9 assessments per child. The median time between first and last DXA recorded was 6.2 years (0.7-16.6). At the first DXA, 14 children (45%) had a LBM. TBMC increased by +0.1 ± 0.04 SD per year of HPN (P = .012). The risk of LBM decreased with an odds ratio of 0.9 per year of HPN (95% confidence interval, 0.92-0.99; P = .018). Lean mass z score and calcium parenteral intakes were related to the TBMC improvement.
  
  
  CONCLUSIONS
  LBM is common in pediatric IF, but bone status could improve during HPN in these children.
authors.affiliation: Hepatology, Gastroenterology and Pediatric Nutrition Unit, Femme Mere Enfant Hospital, Hospices Civils de Lyon, University Claude Bernard Lyon 1, Lyon, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Poinsot
authors.affiliation: Hepatology, Gastroenterology and Pediatric Nutrition Unit, Femme Mere Enfant Hospital, Hospices Civils de Lyon, University Claude Bernard Lyon 1, Lyon, France.
authors.forename: Perrine
authors.initials: P
authors.lastname: Geoffroy
authors.affiliation: Radiology Department, Hopital Femme Mere Enfant, Hospices Civils de Lyon, Lyon, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Braillon
authors.affiliation: Medical Information and Research Analysis Department, Hospices Civils de Lyon, Lyon, France.
authors.forename: Angelique
authors.initials: A
authors.lastname: Denis
authors.affiliation: Hepatology, Gastroenterology and Pediatric Nutrition Unit, Femme Mere Enfant Hospital, Hospices Civils de Lyon, University Claude Bernard Lyon 1, Lyon, France.
authors.forename: Irene
authors.initials: I
authors.lastname: Loras-Duclaux
authors.affiliation: Hepatology, Gastroenterology and Pediatric Nutrition Unit, Femme Mere Enfant Hospital, Hospices Civils de Lyon, University Claude Bernard Lyon 1, Lyon, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Marotte
authors.affiliation: INSERM U1033, Lyos, Pathophysiology, Hospices Civils de Lyon, Lyon, France.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Boutroy
authors.affiliation: INSERM U1033, Lyos, Pathophysiology, Hospices Civils de Lyon, Lyon, France.|Pediatric Nephrology, Rheumatology, Dermatology Unit, Femme Mere Enfant Hospital, Hospices Civils de Lyon, University Claude Bernard Lyon 1, Lyon, France.
authors.forename: Justine
authors.initials: J
authors.lastname: Bacchetta
authors.affiliation: Medical Information and Research Analysis Department, Hospices Civils de Lyon, Lyon, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Touzet
authors.affiliation: Hepatology, Gastroenterology and Pediatric Nutrition Unit, Femme Mere Enfant Hospital, Hospices Civils de Lyon, University Claude Bernard Lyon 1, Lyon, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Lachaux
authors.affiliation: Hepatology, Gastroenterology and Pediatric Nutrition Unit, Femme Mere Enfant Hospital, Hospices Civils de Lyon, University Claude Bernard Lyon 1, Lyon, France.|INSERM U1060, CarMeN laboratory, Hospices Civils de Lyon, F-69003 Lyon, France.
authors.forename: Noel
authors.initials: N
authors.lastname: Peretti
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D001823:Body Composition; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000453:epidemiology* / Q000209:etiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007234:Infant, Premature; D007410:Intestinal Diseases / Q000628:therapy*; D008137:Longitudinal Studies; D008297:Male; D016331:Parenteral Nutrition, Home / Q000009:adverse effects*; D012778:Short Bowel Syndrome / Q000628:therapy; D013997:Time Factors
keywords: bone health; dual-energy x-ray absorptiometry; intestinal failure; life cycle; metabolic bone disease; nutrition; parenteral nutrition; pediatrics; short bowel syndrome