Bone mineral density in children with non-cystic fibrosis bronchiectasis

Abstract

Background: Bronchiectasis presents as a common sequela of several chronic pulmonary diseases. Bone mineral density ( BMD) is generally decreased in children with cystic fibrosis ( CF). Although children with non-CF bronchiectasis have similar risk factors for osteopenia/osteoporosis, data on BMD in this group of patients are lacking. Objective: To evaluate BMD in children with non-CF bronchiectasis. Methods: In this study, we evaluated BMD of the radius and tibia in 32 children ( 17 girls) with non-CF bronchiectasis and in 23 healthy controls matched for age, sex and pubertal stage by quantitative ultrasound ( speed of sound). Daily calcium intake and pulmonary function tests and data about steroid use were noted. Results: Mean age was 12.5 +/- 4.6 years. Six children ( 18%) had moderate-to-severe lung disease (FEV1 < 60% predicted). All except 2 children ( 94%) were receiving inhaled steroids. There was no significant difference in BMD ( expressed as z- score) of the radius and tibia between the patient and control groups ( tibia z-scores: - 0.1+/-0.9 vs. - 0.8 +/- 0.8 and radius z- scores - 1.3 +/- 1.4 vs. - 1.0 +/- 0.9 in bronchiectasis patients and controls, respectively, p >0.05). However, more children with non-CF bronchiectasis had osteopenia ( z- scores between - 1 and - 2 SD) and osteoporosis ( z- score <= 2 SD) compared to the control group ( 62 vs. 30%, p = 0.019). There was a significant correlation between age and radius z- scores ( r = - 0.365, p = 0.04). There was no correlation between BMD and severity of lung illness, calcium intake or cumulative steroid doses. Conclusion: Osteopenia is more common in children with non-CF bronchiectasis compared to controls and the risk of osteoporosis and osteopenia increases with age. Copyright (C) 2007 S. Karger AG, Basel.