Association between respiratory function and bone mineral density in pubertal and prepubertal healthy children

Yıl 2012, Cilt: 4 Sayı: 1, 1 - 10, 29.02.2012

Ahmet Ozen Hulya Saricoban Mustafa Berber Nagihan Sen Sabihe Yesilyurt Sevda Ozdogan Reha Cengizlier

Öz

Aim: We aimed to evaluate whether the variation in bone mineral density (BMD) measures correlates with the respiratory function parameters and to determine the association between lung function tests and anthropometric indices in healthy pubertal and prepubertal children.
Methods: We recruited 73 school children. Primary school students were representing prepubertal children and high school students were representing pubertal children. Data collection included a questionnaire and measures of anthropometry, respiratory function and BMD. We investigated the associations between BMD with spirometric parameters and anthropometry with spirometric parameters controlling for pubertal status and other relevant variables.
Results: We studied 73 school children (36 prepubertal and 37 pubertal; mean age=12.47±4.26 years). Mean BMD z-score values were significantly different between FEV1 percent predicted quartiles which showed a tendency to increase with the trend in FEV1 percent predicted quartiles. In addition, there was a significant correlation between BMD SOS values and PEF percent predicted values. However, in models controlling for possible confounders, this association of BMD SOS with PEF percent predicted values vanished. When controlled for puberty, FVC percent predicted values were positively associated with BMI SDS (r=0.35, p=0,004) and MAC (r=0.29, p=0.018) and FEV1/FVC percent predicted values were negatively correlated with BMI SDS (r=-0.40, p=0.001) and MAC (r=-0.485, p<0.001). The FEV1/FVC percent predicted values were significantly lower in the overweight group than in non-overweight group.
Conclusion: Although the measures of BMD correlate with respiratory function parameters, this association is likely to arise from common influential factor or factors, rather than being a cause-effect relationship.

Anahtar Kelimeler

respiratory function, bone mineral density, healthy children

Kaynakça

• Forbes GB. Some remarks on bone mineralization. J Pediatr. 1988;113:167–171.
• Southard RN, Morris JD, Mahan JD, et al. Bone mass in healthy children: measurement with quantitative DXA. Radiology. 1991;179:735–738.
• Saggese G, Baroncelli GI, Bertelloni S. Puberty and bone development. Best Pract Res Clin Endocrinol Metab. 2000;16:53–64.
• Matkovic V. Skeletal development and bone turnover revisited. J Clin Endocrinol Metab. 1996;81:2013–6.
• Plotkin H, Nunez M, Alvarez Filgueira ML, Zanchetta JR. Lumbar spine bone density in Argentine children. Calcif Tissue Int. 1996;58:144–149.
• Boot AM, de Ridder AJ, Pols APH. Bone mineral density in children and adolescents: relation to puberty, calcium intake, and physical activity. J Clin Endocrinol Metab. 1997;82:57–62.
• Gale CR, Martyn CN, Kellingray S, et al. Intrauterine programming of adult body composition. J Clin Endocrinol Metab. 2001;86:267–72.
• Cooper C, Cawley M, Bhalla A, et al. Childhood growth, physical activity, and peak bone mass in women. J Bone Miner Res. 1995;10:940–7.
• Elkin SL, Fairney A, Burnett S, et al. Vertebral deformities and low bone mineral density in adults with cystic fibrosis: a crosssectional study. Osteoporos Int. 2001;12:366–72.
• Nishimura Y, Nakata H, Maeda H, Yokoyama M. Bone mineral content in patients with bronchial asthma. Nihon Kyobu Shikkan Gakkai Zasshi. 1995;33:300–5.
• Lekamwasam S, Trivedi DP, Khaw KT. An association between respiratory function and bone mineral density in women from the general community: a cross sectional study. Osteoporos Int. 2002;13:710-5.
• Lekamwasam S, Trivedi DP, Khaw KT. An association between respiratory function and hip bone mineral density in older men: a cross-sectional study. Osteoporos Int. 2005;16:204-7.
• Tanner JM: "Growth at Adolescence, with a General Consideration of the Effects of Hereditary and Environmental Factors upon Growth and Maturation from Birth to Maturity," 2nd ed. Oxford: Blackwell, 1962
• US Department of Agriculture. National Nutrient Database for Standard Reference, Release 17. http://www.nal.usda.gov/fnic/foodcomp/Data/SR17/wtr ank/sr17a301.pdf
• Institute of Medicine. Dietary Reference Intakes for Calcium, Phosphorous, Magnesium, Vitamin D, and Fluoride. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board. Washington, DC: National Academy Press; 1997
• http://www.cdc.gov/growthcharts/percentile_data_files. htm
• Gonnelli S, Cepollaro C. The use of ultrasound in the assessment of bone status. J Endocrinol Invest. 2002;25:389–97.
• Knapp KM, Blake GM, Spector TD, Fogelman I. Multisite quantitative ultrasound: precision, age-and menopause-related changes, fracture discrimination, and T-score equivalence with dual-energy X-ray absorptiometry. Osteoporosis Int. 2001;12:456–64.
• Zadik Z, Price D, Diamond G. Pediatric reference curves for multisite quantitative ultrasound and its modulators. Osteoporosis Int. 2003;14:857–62.
• Miller MR, Hankinson J, Brusasco V, et al. Standardisation 2005;26:319-38. Eur Respir J.
• Polgar G. Pulmonary function tests in children. J Pediatr. 1979;95:168-170.
• Turner CH, Burr DB. Basic biomechanical measurements of bone: a tutorial. Bone 1993;14:595– 608.
• Kanis JA, Gluer CC. An update on the diagnosis and assessment Committee of Scientific Advisors International Osteoporosis 2000;11:192–202. with densitometry. Foundation. Osteoporos Int.
• Shane E, Silverberg SJ, Donovan D, Papadopoulos A, Staron BB, Addesso V, et al. Osteoporosis in lung transplantation candidates with end-stage pulmonary disease. Am J Med. 1996;101:262–69.
• Sin DD, Man JP, Man SF. The risk of osteoporosis in Caucasian men and women with obstructive airways disease. Am J Med. 2003;114:10–14.
• Guran T, Turan S, Karadag B, et al. Bone mineral density bronchiectasis. Respiration. 2008;75:432-36. with non-cystic fibrosis
• Katsura H, Kida K. A comparison of bone mineral density in elderly female patients with COPD and bronchial asthma. Chest 2002;122:1949–55.
• Conway SP, Wolfe SP, Brownlee KG, et al. Vitamin K status among children with cystic fibrosis and its relationship to bone mineral density and bone turnover. Pediatrics. 2005;115: 1325–31.
• Sermet-Gaudelus I, Souberbielle J-C, Ruiz JC, et al. Low bone mineral density in young children with cystic fibrosis. Am J Respir Crit Care Med. 2007;175:951–57.
• Seibel MJ. Biochemical markers of bone turnover: part 1 Biochemistry and variability. Clin Biochem Rev. 2005;26:97–122.
• Henderson RC, Madsen CD. Bone density in children and adolescents with cystic fibrosis. J Pediatr. 1996;128:28–34.
• Grey V, Atkinson S, Drury D, et al. Prevalence of low bone mass and deficiencies of vitamins D and K in pediatric patients with cystic fibrosis from 3 Canadian centers. Pediatrics. 2008 ;122:1014-20.
• Malkia E, Impivaara O. Intensity of physical activity and respiratory function in subjects with and without bronchial asthma. Scand J Med Sci Sports 1998;8:27– 32.
• Ford ES, Heath GW, Mannino DM, Redd SC. Leisure- time physical activity patterns among US adults with asthma. Chest. 2003;124:432–437.
• Incalzi RA, Caradonna P, Ranieri P, et al. Correlates of osteoporosis in chronic obstructive pulmonary disease. Respir Med 2000;94:1079–84.
• Ward KD, Klesges RC. A meta-analysis of the effects of cigarette smoking on bone mineral density. Calcif Tissue Int. 2001;68:259–270.
• Kamischke A, Kemper DE, Castel MA, et al. Testosterone levels in men with chronic obstructive pulmonary disease with or without glucocorticoid therapy. Eur Respir J. 1998;11:41–45.
• Dimai HP, Domej W, Leb G, Lau KH. Bone loss in patients with untreated chronic obstructive pulmonary disease is mediated by an increase in bone resorption associated with hypercapnia. J Bone Miner Res. 2001;16:2132–41.
• Holliday MA. Body composition and energy needs during growth. In: Falkner F, Tanner JM, editors. Human growth, postnatal growth. New York: Plenum; 1986. p 101–117.
• Cheek DB. Body composition, hormones, nutrition and adolescent growth. In: Grumbach MM, Grave GD, Mayer FE, editors. Control of the onset of puberty. New York: John Wiley & Sons; 1974. 424–447.
• Forbes GB. Body composition in adolescence. In: Falkner F, Tanner JM, editors. Human growth, post- natal growth. New York: Plenum; 1986. p 119–145.
• Ohlsson C, Bengtsson BA, Isaksson OG, Andreassen TT, Slootweg MC. Growth hormone and bone. Endocr Rev. 1998;19:55–79.
• Frank GR. The role of estrogen in pubertal skeletal physiology: Epiphyseal maturation and mineralization of the skeleton. Acta Paediatr. 1995;846:627–630.
• Rogol AD, Roemmich JN, Clark AP. Growth at puberty. J Adolesc Health. 2002;31:192–200.
• Li AM, Chan D, Wong E, Yin J, Nelson EA, Fok TF. The effects of obesity on pulmonary function. Arch Dis Child. 2003;88:361-363.
• Ulger Z, Demir E, Tanaç R, et al. The effect of childhood obesity on respiratory function tests and 10 airway 2006;48:43-50. Turk J Pediatr.
• Thomas PS, Cowen ER, Hulands G, Milledge JS. Respiratory function in the morbidly obese before and after weight loss. Thorax. 1989;44:382-386.
• Inselma LS, Milanese A, Duerloo A. Effects of obesity on pulmonary function in children. Pediatr Pulmonol. 1993;16:130-137.
• Lazarus R, Colditz G, Berkey CS, Speizer FE. Effects of body fat on ventilatory function in children and adolescents: cross-sectional findings from a random population sample of school children. Pediatr Pulmonol.1997;24:187-194.
• Zerah F, Harf A, Perlemuter L, Lorino H, Lorino A. Effects of obesity on respiratory resistance. Chest. 1993;103:1470-76.