Clinical features associated with impaired bone health in yo
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The aim of this study is to stratify clinical factors that influence future bone health in the Australian CF population and use this information to direct a more streamlined approach to bone health screening. For Australians suffering from Cystic Fibrosis (CF), improved survival necessitates a greater focus on long term endocrine sequelae such as CFrelated bone disease. Bone mass accrual deficits are most likely to occur during childhood and adolescence. In Australia, existing recommendations recommend repeat dualenergy xray absorptiometry (DXA) scans every two years.

This study was a retrospective audit of all 453 patients diagnosed with CF who were treated at the Royal Children's Hospital. 202 patients had a DXA scan in the study period (191 with height-adjusted data) and 111 patients had more than one scan (108 with height adjusted data). An investigation into the associations between bone mineral density (BMD) Z score and potential risk factors was conducted using DXA and historical data.

--The main predictor of future BMD was previous BMD Z score.

--Other factors found to be determinants of BMD included nutritional status, lung function (FEV1), age, history of previous fracture, oral corticosteroid use and number of hospital admissions.

--However, after adjusting for previous BMD, evidence of an association remained only with nutritional status, FEV1 and number of hospital admissions.

In conclusion, second-year scans may be unnecessary in children who have an acceptable DXA score on their initial scan and are clinically stable. Clinical degradation in those with previously normal bone mineral density, on the other hand, may necessitate closer monitoring of bone health.