Bone mineral density, vertebral deformities prevalence and bone fractures in adult cystic fibrosis patients

Summary. The aim of this study was to determine the prevalence of low bone mineral density (BMD), minimal trauma fractures and thoracic and lumbar vertebral deformities in cystic fibrosis (CF) adults and also to assess the correlation between BMD, minimal or no trauma fractures and vertebral deformities with other CF characteristics.

We studied 130 adults with CF (16–42 years old; 63 men, 67 women). Lumbar spine, and proximal femur (in patients of 19 and older) BMD were measured by dual-energy X-ray absorptiometry. Lumbar spine measurement was performed in 130 patients, proximal femur – in 89 patients. Spinal radiographs (lateral and anterior posterior views) were taken in 26 patients with low BMD for assessment of vertebral fractures. Chest radiographs were graded using Genant's semi-quantitative method to identify and assess vertebral deformities. A range of anthropometric, clinical, functional and genetic variables were evaluated as potential correlates. BMD Z-score lower than –2 SD was observed in 42.2 % patients, and in 36,2 % this value was between –1 and –2 SD.

BMD values were significantly related to lung function (FEV1, FVC, FEV1 / FVC), BMI, SpO2, dispnoea by MRC scale, steroid intake and the amount of daily physical activity. Minimal trauma fractures were identified in 10.0 % of the patients. No correlation was found between peripheral bone fractures and gender, anthropometric, functional, clinical or genetic characteristics. Vertebral deformities were observed in 50 % of patients with low BMD. This study indicates that osteoporosis is a common complication of CF, being related to lung disease severity and low BMI.

cystic fibrosis, fractures, vertebral deformities, low bone mineral density

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