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Abstract：
Longitudinal changes in bone health in children with intestinal failure (IF) are unclear. We aimed to better understand the trajectory of bone mineral status over time in children with IF and identify clinical factors that influence the trajectory.
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.
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.
摘要：
背景：肠衰竭儿童骨骼健康的纵向变化尚不清楚。我们旨在更好地了解肠衰竭患儿骨矿物质状态随时间的轨迹，并确定影响轨迹的临床因素。
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。
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。
