Decreased bone mineral density in young adults treated with SCT in childhood: the role of 25-hydroxyvitamin D.
Bone Marrow Transplant. 2011 Jul 18. doi: 10.1038/bmt.2011.147.
Frisk P, Arvidson J, Ljunggren O, Gustafsson J.
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
We measured bone mineral density (BMD) with dual-energy X-ray absorptiometry in the total body, at the lumbar spine, at the femoral neck and in the total hip, in 18 young adults with a median of 18.2 years after SCT. Fifteen patients had undergone auto-SCT and all patients had received TBI. The patients had significantly lower BMD in the total body, at the femoral neck, and in the total hip compared with age- and sex-matched controls.
- Six of 18 patients (33%) had low bone mass (z-score <-1) at one or more measurement sites,
- as opposed to two of the controls (11%, P=0.29).
We found no significant influence of growth hormone levels or of untreated hypogonadism on BMD variables. Levels of 25-hydroxy OH vitamin D were lower among the patients (35.2 vs 48.8?nmol/L, P=0.044) and were significantly correlated with total body BMD in the patient group (r=0.55, P=0.021).
All six patients with low bone mass had hypovitaminosis D (< 37?nmol/L as opposed to 4 of the 11 (36%) patients without low bone mass (P=0.035).
In conclusion, we found decreased BMD in SCT survivors, which may in part be caused by 25(OH) vitamin D deficiency.
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