A prospective case-control pilot study to evaluate bone microarchitecture in children and teenagers on long-term parenteral nutrition using HR-pQCT

Sci Rep. 2021 Apr 28;11(1):9151. doi: 10.1038/s41598-021-88366-6.

Abstract

Long-term parenteral nutrition (PN) may induce bone complications. Tridimensional bone imaging techniques such as high-resolution peripheral quantitative computed tomography (HR-pQCT) allow the assessment of both compartmental volumetric densities and microarchitecture. Our aim was to evaluate these parameters in children and teenagers receiving long-term PN. This cross-sectional, case-control study included children older than 9 years undergoing PN for at least 2 years. They were age-, gender- and puberty-matched with healthy controls (1:2). Evaluation included biological assessment of bone metabolism (serum calcium, phosphate, and albumin; urinary calcium and creatinine; 25-OH vitamin D, osteocalcin and PTH), dual X-ray absorptiometry (DXA) and HR-pQCT at the ultradistal tibia and radius. Results are presented as median [range]. Eleven patients (3 girls) with a median age of 16 [9-19] years were included. Bone parameters assessed by HR-pQCT at the ultradistal radius and tibia were similar in patients and controls. Parathyroid hormone (PTH) levels were higher (14 [7-115] vs 16 [12-27]) and osteocalcin levels were lower (44 [15-65] vs 65 [38-142]) in patients than in controls, although within the normal range. Conclusions: there were no differences for compartmental bone densities and microarchitecture in patients undergoing chronic PN. Further longitudinal studies are required to confirm these quite reassuring preliminary results.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adolescent
  • Bone Density
  • Bone Diseases, Metabolic / therapy
  • Bone and Bones / diagnostic imaging
  • Bone and Bones / metabolism*
  • Bone and Bones / ultrastructure
  • Case-Control Studies
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Osteocalcin / blood
  • Parathyroid Hormone / blood
  • Parenteral Nutrition, Total*
  • Pilot Projects
  • Radius / diagnostic imaging
  • Radius / metabolism
  • Radius / ultrastructure
  • Tibia / diagnostic imaging
  • Tibia / metabolism
  • Tibia / ultrastructure
  • Tomography, X-Ray Computed
  • Young Adult

Substances

  • Parathyroid Hormone
  • Osteocalcin