Fluoride exposure and bone status in patients with chronic intestinal failure who are receiving home parenteral nutrition
| Autor: | Pierre D. Delmas, Cécile Chambrier, Elisabeth Fontanges, Christel Gutknecht, M. Lauverjat, Muriel Bost, René Ecochard, P. Boulétreau |
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| Přispěvatelé: | Biostatistiques santé, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS) |
| Jazyk: | angličtina |
| Rok vydání: | 2006 |
| Předmět: |
Adult
Male Short Bowel Syndrome medicine.medical_specialty Fluoride Poisoning [SDV.OT]Life Sciences [q-bio]/Other [q-bio.OT] Osteoporosis Medicine (miscellaneous) 030209 endocrinology & metabolism Gastroenterology Bone and Bones Bone remodeling Metabolic bone disease Fluorides 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Bone Density Internal medicine Humans Medicine 030212 general & internal medicine Aged Retrospective Studies Femoral neck Bone mineral Nutrition and Dietetics business.industry Middle Aged medicine.disease 3. Good health Surgery Parenteral nutrition medicine.anatomical_structure chemistry Linear Models Female Parenteral Nutrition Home business Fluoride |
| Zdroj: | American Journal of Clinical Nutrition American Journal of Clinical Nutrition, American Society for Nutrition, 2006, 83, pp.1429-1437 The American Journal of Clinical Nutrition The American Journal of Clinical Nutrition, 2006, 83, pp.1429-1437 |
| ISSN: | 0002-9165 1938-3207 |
| Popis: | Background and objective Metabolic bone disease is frequent in chronic intestinal failure. Because fluoride has a major effect on bones, the status of both fluoride and bone was studied in long-term home parenteral nutrition (HPN) patients. Design We studied 31 adults aged (x +/- SD) 56.3 +/- 15.1 y, mainly patients with short-bowel syndrome, who had been receiving HPN for >1 y. Bone mineral density (BMD) was measured by absorptiometry, and serum fluoride was measured by using a fluoride-sensitive electrode. All patients ate and drank ad libitum. HPN (3.4 +/- 1.2 times/wk) complemented oral nutrition. Potential explicative factors were estimated by using a linear regression model (mixed-effects model). Results Of 120 fluoride dosages (2-6/patient), 102 were above the upper normal limit (1.58 micromol/L) at the laboratory. Mean (+/- SD) daily fluoride supply was 8.03 +/- 7.71 mg (US adequate intake: 3.1 mg/d for women and 3.8 for men; tolerable upper normal limit: 10 mg/d); intravenous fluoride varied from 0.06 to 1.45 mg, and oral fluoride varied from 0.09 to 27.8 mg. Serum fluoride concentrations were correlated with creatinine clearance and fluoride supply. BMD was significantly lower in the femoral neck than in the spinal area. After adjustment for sex and the duration of HPN, only the effect of serum fluoride on spinal BMD was significant. Two patients had symptoms of fluorosis, eg, calcaneum fissures, interosseous calcifications, or femoral neck osteoporosis. Conclusions In chronic intestinal failure, high intakes of fluoride are frequent because of the beverages ingested to compensate for stool losses. Hyperfluoremia has an effect on bone metabolism and may increase skeletal fragility. The consumption of fluoride-rich beverages for extended periods is therefore not advisable. |
| Databáze: | OpenAIRE |
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