An update on methods for assessing bone quality and health in Cystic fibrosis.

Autor:	Williams KM; Division of Pediatric Endocrinology, Diabetes, and Metabolism, Columbia University Irving Medical Center, 1150 St Nicholas Avenue, New York, NY, USA., Darukhanavala A; Division of Pediatric Endocrinology, University of Massachusetts Medical Center, 55 Lake Ave North, Worcester, MA, USA., Hicks R; Division of Pediatric Endocrinology, David Geffen School of Medicine, UCLA, 10833 Le Conte Ave, MDCC 22-315, Los Angeles, CA, USA., Kelly A; Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, 2716 South Street, Philadelphia, PA, USA.
Jazyk:	angličtina
Zdroj:	Journal of clinical & translational endocrinology [J Clin Transl Endocrinol] 2021 Dec 06; Vol. 27, pp. 100281. Date of Electronic Publication: 2021 Dec 06 (Print Publication: 2022).
DOI:	10.1016/j.jcte.2021.100281
Abstrakt:	With increasing life expectancy in people with Cystic fibrosis (CF), the focus of clinical care has shifted to management and prevention of non-pulmonary comorbidities. CF related bone disease, defined by low bone mineral density (BMD), is prevalent across all age groups and acknowledges the increased fractures rates that negatively impact lung function and quality of life. Dual energy X-ray absorptiometry (DXA) measurement of bone mineral content (BMC) and "areal" BMD (aBMD) is recommended for identifying and monitoring bone health in children and adults due to its low cost, low radiation exposure, and widespread availability. Recent studies in children and adolescents with chronic illness focus on adjustment of BMC and aBMD measurements for height due to the effects of short stature and delayed maturation on bone size. Expanded reference databases for alternate imaging sites such as the ultradistal radius and hip present opportunities for research and long-term monitoring. As the two-dimensional nature of DXA imposes limitations, we highlight other imaging modalities including peripheral quantitative computed tomography QCT (pQCT), magnetic resonance imaging, and quantitative ultrasound (QUS). These tools, while primarily used in a research setting, can impart information on true volumetric bone density and bone microarchitecture as well as contribute to fracture assessment and prediction. Due to the high morbidity and mortality associated with vertebral and hip fracture, we will present on vertebral fracture assessment (VFA) in both children and adults as well as applied analyses including hip structural analysis (HSA), trabecular bone score (TBS), and fracture risk assessment (FRAX) for high risk groups. Questions remain on the future clinical applicability and accessibility of these assessment and prediction tools, longitudinal monitoring through adolescence and adulthood, and how outcome measures may guide bone modifying therapies. Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (© 2021 The Authors.)
Databáze:	MEDLINE
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