Clinical records of patients attending the Intestinal Rehabilitation Center of Cincinnati Children\'s Hospital Medical Center between 2012 and 2021 were reviewed. Children diagnosed with IF before age 3 years with at least two lumbar spine dual-energy x-ray absorptiometry scans were included. We abstracted information on medical history, parenteral nutrition, bone density, and growth. We calculated bone density z scores with and without adjustment for height z scores.
Thirty-four children with IF met inclusion criteria. Children were shorter than average with a mean height z score of -1.5 ± 1.3. The mean bone density z score was -1.5 ± 1.3 with 25 of the cohort having a z score < -2.0. After height adjustment, the mean bone density z score was -0.42 ± 1.4 with 11% below -2.0. Most dual-energy x-ray absorptiometry scans (60%) had a feeding tube artifact. Bone density z scores increased slightly with age and lower parenteral nutrition dependency and were higher in scans without an artifact. Etiologies of IF, line infections, prematurity, and vitamin D status were not associated with height-adjusted bone density z scores.
Children with IF were shorter than expected for age. Deficits in bone mineral status were less common when adjusting for short stature. Etiologies of IF, prematurity, and vitamin D deficiency were not associated with bone density.
方法:回顾2012-2021年辛辛那提儿童医院医疗中心肠道康复中心患者的临床记录。纳入3岁前诊断为IF的儿童,腰椎双能量X射线吸收法扫描≥2次。我们提取了病史信息,肠外营养,骨密度,和增长。我们计算骨密度Z评分,有和没有调整身高Z评分。
结果:34例肠衰竭患儿符合纳入标准。儿童短于平均水平,平均身高Z评分为-1.5±1.3。平均骨密度Z评分为-1.5±1.3,其中25%的组群具有<-2.0的Z评分。高度调整后,平均骨密度Z评分为-0.42±1.4,11%低于-2.0。大多数DXA扫描(60%)具有饲管伪影。骨密度Z评分随着年龄的增长和肠外营养依赖性的降低而略有增加,并且在没有伪影的扫描中更高。肠衰竭的病因,线感染,早产和维生素D状态与身高校正骨密度Z评分无关.
结论:肠衰竭患儿的年龄短于预期。调整身材矮小时,骨矿物质状态的缺陷较少见。肠衰竭的病因,早产,维生素D缺乏与骨密度无关。本文受版权保护。保留所有权利。