According to the DEXA scan Z-scores, bone mineral density was significantly lower among children with CLD, and was correlated with alkaline phosphatase (ALP) and the duration of disease.
Abstract
Reduced bone density is a common complication of chronic liver disease (CLD) in both adults and children. Factors contributing to bone mineral deficits are dependent on the pathophysiology and severity of the underlying liver disease. This case-control study aims to assess the bone mineral density in children (4-13 years old) suffering from CLD, using a dual-energy X-ray absorptiometry (DEXA) scan. The study was conducted in the Children’s Welfare Teaching Hospital (Baghdad, Iraq) from 1 November 2023 to 1 November 2024. Bone mineral density has been assessed by DEXA scan for 78 patients and controls in the pediatric age group. The mean Z-score was −0.44 among patients and 0.45 among the control group. This difference was statistically significant (p=0.02). According to the DEXA scan Z-scores, bone mineral density was significantly lower among children with CLD. Bone mineral density was correlated with alkaline phosphatase (ALP) and the duration of disease. Although there was a difference in Z-score levels across different disease types, this difference did not reach statistical significance.
The findings suggest that the clinical role of TBS in the assessment of pediatric bone health remains to be established, and that larger prospective studies are needed to clarify the clinical value of TBS for fracture risk assessment in pediatric autoimmune gastrointestinal diseases.
Anna Łupińska, Sara Aszkiełowicz, Arkadiusz Zygmunt et al.· Nutrients· 0 citations
Objectives
Type 1 diabetes (T1D) is a recognized risk factor for skeletal fragility in adults, but its impact on bone microstructure in children remains incompletely characterized. In particular, data on trabecular bone quality remain scarce. This study aimed to evaluate skeletal parameters in this group of children and examine their associations with clinical variables.
Methods
This retrospective cross-sectional study evaluated children with T1D at the Hong Kong Children's Hospital from June 2023 to December 2024. Skeletal parameters, including trabecular bone score (TBS), bone health index (BHI), bone mineral density (BMD) by dual-energy x-ray absorptiometry, and serum vitamin D and HbA1c levels, were evaluated alongside fracture history. A parent-reported questionnaire measured participation in physical activity. Correlations between bone parameters and clinical variables were analyzed.
Results
Sixty-eight children with T1D (male 42.6%, mean 12.7 ± 3.7 years, 44.1% prepubertal, mean HbA1c 7.3%) were included. A substantial proportion of children (19.6%) had low cortical bone density as reflected by BHI Z-score ≤ -2, whereas deficits in trabecular bone (TBS Z-score ≤ -2) were less common (4.8 %). Regression analysis confirmed that higher lean mass was associated with higher total body less head (TBLH), lumbar spine (LS) and TBS Z-scores (β=0.0001, p < 0.05), while disease duration had a negative association with these measurements (β=-0.1413; β =-0.1335, β=-0.2270, p < 0.05).
Conclusion
In this cohort of children with T1D, a pattern of skeletal involvement was observed, characterized by a high prevalence of low BHI Z-scores and a relatively low prevalence of low TBS Z-scores. This may suggest differential involvement of cortical bone with relative preservation of trabecular microarchitecture. Whether these structural differences translate into fracture risk remains unknown. Longitudinal studies are needed to elucidate the evolution of bone alterations over time and to identify determinants underlying skeletal vulnerability in childhood-onset diabetes. Higher lean mass was associated with higher bone mass and microarchitectural indices, whereas longer disease duration may have a negative association with these parameters. These findings highlight modifiable and disease-related factors that may influence bone health, warranting confirmation in larger controlled studies.
S. W. Poon, Jian-Fang Zhu, Gloria S. W. Pang et al.· Journal of Clinical Research...· 0 citations
Background: Metabolic bone disease (MBD) in children with chronic kidney disease (CKD) is associated with high morbidity and mortality, and it has been reported that it starts early in the course of the disease and worsens as the kidney damage progresses. Therefore, we aimed to determine the magnitude and pattern of mineral bone disease among patients with chronic kidney disease on follow-up at the pediatric renal clinic of Tikur Anbessa Specialized Hospital in Addis Ababa.
Methods: An institution-based cross-sectional study with retrospective data collection was conducted on 86 children with CKD from stages 1 to 5. The study was conducted at Tikur Anbessa Specialized Hospital, Department of Pediatrics and Child Health, renal unit, from September 2024 to February 2025. Blood levels of Ca, P, PTH, alkaline phosphatase, and 25-Hydroxyvitamin D (25 OHD) were checked from patient records, and the prevalence of MBD according to the stages of CKD was assessed.
Results: The age range is from 6 months to 15 years, including 53 males and 33 females, with a male-to-female ratio of 1.6:1. The prevalence of hypocalcemia increased with CKD stages: 12.2%, 36.8%, and 71.3% for stages 3, 4, and 5, respectively. Similarly, hyperphosphatemia was observed in 24.4%, 21.1%, and 42.9% of patients across stages 3, 4, and 5. The prevalence of hyperparathyroidism was 79.3%, 86.7%, and 100% at stages 3, 4, and 5. The prevalence of high total alkaline phosphatase increased from 4% to 21.1% and 28.6% across those stages. Similarly, the prevalence of low 25-OHD rose significantly with increasing CKD stage: 71.1%, 73.7%, and 100% at stages 3, 4, and 5.
Conclusion: The results demonstrated that mineral bone disorders are common in Ethiopian children with CKD in a single facility, beginning in the early stages and worsening as the disease progresses
D. Shimelis, Woldemariam Asmare· Ethiopian journal of pediatr...· 0 citations
Evaluation of skeletal health in children with OI should not rely solely on BMD measurements; vertebral fractures, biochemical markers, growth, and environmental factors should also be considered.
Banu Turhan, N. Yaşar· Turkish Journal of Pediatric...· 0 citations
BACKGROUND
Computed tomography (CT)-defined bone mineral density (BMD) is a promising quantitative imaging marker that reflects the overall condition of patients, which was demonstrated in several diseases.
OBJECTIVE
The present multicentric study aimed to demonstrate the prognostic role of BMD in patients with acute PE.
METHODS AND RESULTS
The investigated patient sampled was comprised of 829 patients (355 female, 42.8%) with a mean age of 64.1 ± 15.8 years. The primary endpoint of this study was 30-day mortality. The simplified pulmonary embolism index (sPESI) was calculated as a clinical prognostic score. Logistic binary regression analyses were used to test the associations between BMD and 30-day mortality. A total of 94 patients (11.3%) died within the 30-day observation period. A weak inverse association was identified between BMD and sPESI score (r = -0.21, p <0.0001). Low BMD showed an association with 30-day mortality with an odds ratio (OR) of 2.26 (95% confidence interval [CI], 1.24 - 4.10; p = 0.008 in univariable analysis) and 2.39 (95% CI, 1.24 -4.44; p = 0.007) in multivariable analysis.
CONCLUSION
Using the threshold value of 75 HU, bone mineral density is a prognostic factor in patients with acute pulmonary embolism. However, this threshold value is lower than the values previously proposed for diagnosing osteoporosis.
Hans-Jonas Meyer, M. Hinnerichs, Anar Aghayev et al.· Heart & lung : the journal o...· 0 citations
Findings support the need for routine bone health screening in patients with AOSD and demonstrate a high burden of impaired bone health in patients with AOSD.
Yong-Jun Choi, Ji-Won Kim, Ju-Yang Jung et al.· Medicine· 0 citations
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