乳糜泻儿童骨密度的评估

IF 0.4 4区医学 Q4 PEDIATRICS

Iranian Journal of Pediatrics Pub Date : 2023-08-16 DOI:10.5812/ijp-134470

Didem Gulcu Taskin, Aysun Ata

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引用次数: 0

摘要

背景:骨质疏松症是乳糜泻(CD)患者的一个已知实体。目的:本研究的目的是评估CD患儿的骨密度(BMD)测量值。方法:这是一项回顾性设计研究，在土耳其的一家三级医院进行。结果:共纳入106例患者，平均年龄10.2±3.9岁。平均L1-L4 Z评分为0.730±0.197(基于土耳其儿童性别和身高)。约20.7% (n = 22)有至少一次骨折和/或骨痛病史。与没有骨折的患者组相比，有骨折和/或骨痛病史的患者腰部(L1-L4)椎骨的骨密度值显著降低(分别为0.822±0.242 g/cm2和0.706±0.178 g/cm2);P = 0.047)。体重指数(BMI) SDS值低于-2(中度或重度营养不良)的患者L1-L4 Z评分(基于土耳其儿童的性别和身高)低于BMI SDS高于-2的患者(分别为0.02±1.19 vs 1.4±1.82);P = 0.014)。中度正相关(r = 0.547;生长激素- c (IGF-1)水平与L1-L4骨密度(g/cm2)测定之间的差异有P < 0.01)。值得注意的是，使用身高L1-L4 z评分和土耳其儿童年龄L1-L4 z评分，没有发现任何患者的骨密度低。使用GE Healthcare Lunar iDXA系统的美国年龄和性别特异性L1-L4 z评分，发现9例(8.5%)患者骨密度低。结论:应考虑乳糜泻儿童骨骼健康欠佳的危险因素，对骨密度进行筛查。通过考虑BMD测量装置的模型以及在与土耳其参考值不一致的情况下使用装置的正常范围，可以避免错误的“正常”BMD解释。

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Evaluation of Bone Mineral Density in Children with Celiac Disease

Background: Osteoporosis is a known entity in individuals with celiac disease (CD). Objectives: The aim of this study was to evaluate bone mineral density (BMD) measurements in children with CD. Methods: This was a retrospective design study in a tertiary hospital in Turkey. Results: Totally 106 patients were included, and the mean age was 10.2 ± 3.9 years. The mean L1-L4 Z score was 0.730 ± 0.197 (based on sex and height in Turkish children). About 20.7% (n = 22) had a history of at least one fracture and/or bone pain. Bone mineral density values obtained from lumbar (L1-L4) vertebrae were significantly lower in patients with a prior fracture and/or bone pain compared to the patient group without a fracture (0.822 ± 0.242 g/cm2 vs 0.706 ± 0.178 g/cm2, respectively; P = 0.047). L1-L4 Z score (based on sex and height in Turkish children) was lower in patients with a body mass index (BMI) SDS value below -2 (moderately or severely malnourished) than those with a BMI SDS above -2 (0.02 ± 1.19 vs 1.4 ± 1.82, respectively; P = 0.014). A moderate positive correlation (r = 0.547; P < 0.01) was found between somatomedin-C (IGF-1) level and L1-L4 BMD (g/cm2) measurement. It was remarkable that low BMD was not identified in any patients using L1-L4 Z-score by height and L1-L4 Z-score by age of Turkish children. Nine (8.5%) patients were found to have low BMD using the United States (US) age- and sex-specific L1-L4 Z-score from the GE Healthcare Lunar iDXA system. Conclusions: Bone mineral density should be screened considering risk factors for suboptimal bone health in children with celiac disease. False "normal" BMD interpretations can be avoided by taking into account the model of the BMD measuring device and by using the device's normal ranges in case of inconsistency with the Turkish reference values.

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来源期刊

Iranian Journal of Pediatrics 医学-小儿科

CiteScore

0.90

自引率

20.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Iranian Journal of Pediatrics (Iran J Pediatr) is a peer-reviewed medical publication. The purpose of Iran J Pediatr is to increase knowledge, stimulate research in all fields of Pediatrics, and promote better management of pediatric patients. To achieve the goals, the journal publishes basic, biomedical, and clinical investigations on prevalent diseases relevant to pediatrics. The acceptance criteria for all papers are the quality and originality of the research and their significance to our readership. Except where otherwise stated, manuscripts are peer-reviewed by minimum three anonymous reviewers. The Editorial Board reserves the right to refuse any material for publication and advises that authors should retain copies of submitted manuscripts and correspondence as the material cannot be returned. Final acceptance or rejection rests with the Editors.