The importance of monitoring bone metabolism markers and vitamin D in adult patients with cystic fibrosis
https://doi.org/10.18093/0869-0189-2011-0-6-103-110
Abstract
Summary. In this cross-sectional study, serum osteocalcin (a biomarker of bone formation), β-CrossLaps (a biomarker of bone resorption), and 25(OH)D were assessed in 64 adults with cystic fibrosis (CF) aged 16 to 35. We evaluated relationships between these biomarkers, bone mineral density (BMD), CF-specific clinical, genetic, anthropometric and functional parameters, serum C-reactive protein (CRP), and rate of low trauma peripheral fractures. β-CrossLaps level was significantly increased while osteocalcin concentration was normal or slightly decreased. A level of 25(OH)D was normal in 9.5 % of the patients and decreased in 90.5 % of the patients. Relationships were found between β-CrossLaps, BMD of the neck and the proximal part of the thigh and gender and between 25(OH)D and CF genotype. Bone biochemical biomarkers and 25(OH)D did not correlate with F508del and CFTRdele2,3(21kb) mutations, CPR level and fracture rate. These results provide rationale for initiating antiresorptive therapy in CF patients with low BMD and fractures and for administration of high-dose vitamin D to prevent bone mass reduction.
About the Authors
S. A. Krasovsky
ФГУ "НИИ пульмонологии" ФМБА России
Russian Federation
Russian Federation
I. A. Baranova
ГБОУ ВПО "РНИМУ им. Н.И.Пирогова" Минздравсоцразвития России
Russian Federation
Russian Federation
V. A. Samoilenko
ФГУ "НИИ пульмонологии" ФМБА России
Russian Federation
Russian Federation
E. L. Amelina
ФГУ "НИИ пульмонологии" ФМБА России
Russian Federation
Russian Federation
N. V. Demin
НИИ ревматологии РАМН
Russian Federation
Russian Federation
A. G. Chuchalin
ФГУ "НИИ пульмонологии" ФМБА России; РНИМУ им. Н.И.Пирогова
Russian Federation
Russian Federation
References
1. Cystic Fibrosis Foundation, Patient registry 2009. Annual report Cystic Fibrosis Foundation. Bethesda, Md, USA, 2011. 55.
2. Красовский С.А., Баранова И.А., Демин Н.В. и др. Минеральная плотность костной ткани, частота деформаций позвонков и периферических переломов у взрослых больных муковисцидозом. Пульмонология 2011; 5: 71–78.
3. Ашерова И.К., Ершова О.Б. Костная минеральная плотность у больных муковисцидозом Ярославского регионального центра. Пульмонология 2006; Прил.: 15 лет Российскому центру муковисцидоза: 47–51.
4. Горинова Ю.В. Остеопения при хронических болезнях легких у детей: Автореф. дис. … канд. мед. наук. М.; 2005.
5. Ожегов А.М., Симанова Т.В. Механизмы формирования остеопении у больных муковисцидозом. В кн.: Материалы IX Национального конгресса по муковисцидозу. "Муковисцидоз у детей и взрослых-2009". М.; ЗАО "Рекламно-изд. группа МегаПро"; 2009. 54–56.
6. www.ipaq.ki.se
7. Aris R.M., Ontjes D.A., Buell H.E. et al. Abnormal bone turnover in cystic fibrosis adults. Osteoporos. Int. 2002; 13 (2): 151–157.
8. Flohr F., Lutz A., App E.M. et al. Bone mineral density and quantitative ultrasound in adults with cystic fibrosis. Eur. J. Endocrinol. 2002; 146: 531–536.
9. Baroncelli G., De Luca F., Magazzu G. et al. Bone demineralization in CF: evidence of imbalance between bone formation and degradation. Pediatr. Res. 1997; 41: 397–403.
10. Ionescu A.A., Nixon L.S., Ewans W.D. et al. Bone density, body composition, and inflammatory status in cystic fibrosis. Am. J. Respir. Crit. Care Med. 2000; 162: 789–794.
11. Legroux-Gerota I., Leroyb S., Prudhommea C. et al. Bone loss in adults with cystic fibrosis: Prevalence, associated factors, and usefulness of biological markers. Joint Bone Spine 2011; doi:10.1016/j.jbspin.2011.05.009
12. Haworth C.S., Selby P.L., Webb A.K. et al. Inflammatory related changes in bone mineral content in adults with cystic fibrosis. Thorax 2004; 59: 613–617.
13. Shead E.F., Haworth C.S., Barker H. et al. Osteoclast function, bone turnover and inflammatory cytokines during infective exacerbations of cystic fibrosis. J. Cyst. Fibros. 2010; 9: 93–98.
14. Haworth C.S., Selby P.L., Webb A.K. et al. Low bone mineral density in adults with cystic fibrosis. Thorax 1999; 54: 961–967.
15. King S.J, Topliss D.J, Kotsimbos T. et al. Reduced bone density in cystic fibrosis: delta F508 mutation is an independent risk factor. Eur. Respir. J. 2005; 25: 54–61.
16. Aris R.M., Stephens A.R., Ontjes D.A. et al. Adverse alterations in bone metabolism are associated with lung infection in adults with cystic fibrosis. Am. J. Respir. Crit. Care Med. 2000; 162: 1674–1678.
17. Hall W.B., Sparks A.A., Aris R.M. Vitamin D deficiency in cystic fibrosis. Int. J. Endocrinol. 2010; doi: 10.1155/2010/218691.
18. Grey A.B., Ames R.W., Matthews R.D. et al. Bone mineral density and body composition in adult patients with cystic fibrosis. Thorax 1993; 48: 589–593.
19. Stead R.J., Houlder S., Agnew J. et al. Vitamin D and parathyroid hormone and bone mineralisation in adults with cystic fibrosis. Thorax 1988; 43 (3): 190–194.
20. Hanly J.G., McKenna M.J., Quigley C. et al. Hypovitaminosis D and response to supplementation in older patients with cystic fibrosis. Quart. J. Med. 1985; 56 (219): 377–385.
21. Капустина Т.Ю., Капранов Н.И. Состояние минеральной плотности костной ткани у пациентов с муковисцидозом. Педиатрия 2008; 87 (5): 36–41.
Review
For citations:
Krasovsky S.A., Baranova I.A., Samoilenko V.A., Amelina E.L., Demin N.V., Chuchalin A.G. The importance of monitoring bone metabolism markers and vitamin D in adult patients with cystic fibrosis. PULMONOLOGIYA. 2011;(6):103-110. (In Russ.) https://doi.org/10.18093/0869-0189-2011-0-6-103-110
Views:
703
Email this article 