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Low bone mineral density in adults with complex congenital heart disease

Sandberg, Camilla ; Johansson, Karna ; Christersson, Christina ; Hlebowicz, Joanna LU ; Thilén, Ulf LU and Johansson, Bengt (2020) In International Journal of Cardiology 319. p.62-66
Abstract

Aims: The majority of children with complex congenital heart disease (CHD) survive into adulthood due to advances in medical care. Adult patients with CHD have an increased incidence of diagnoses related to ageing such as heart failure, dementia, cancer and sarcopenia, despite a relatively low age. They also have a shorter life expectancy. It is unknown if their bone structures also show signs of premature ageing. We therefore investigated Bone Mineral Content (BMC) and bone mineral density (BMD) in an adult population with complex CHD. Methods: The total body BMC and BMD was examined using dual energy X-ray absorptiometry (DXA) in 73 adults with complex CHD (mean age 35.8 ± 14.3, women n = 22) and 73 age and sex matched controls.... (More)

Aims: The majority of children with complex congenital heart disease (CHD) survive into adulthood due to advances in medical care. Adult patients with CHD have an increased incidence of diagnoses related to ageing such as heart failure, dementia, cancer and sarcopenia, despite a relatively low age. They also have a shorter life expectancy. It is unknown if their bone structures also show signs of premature ageing. We therefore investigated Bone Mineral Content (BMC) and bone mineral density (BMD) in an adult population with complex CHD. Methods: The total body BMC and BMD was examined using dual energy X-ray absorptiometry (DXA) in 73 adults with complex CHD (mean age 35.8 ± 14.3, women n = 22) and 73 age and sex matched controls. Results: The adults with complex CHD had lower total body BMC (2.6 ± 0.5 kg vs. 2.9 ± 0.5 kg, p < 0.001) and BMD (1.18 ± 0.12 g/cm2 vs. 1.26 ± 0.11 g/cm2, p < 0.001) compared to controls. BMD was lower for patients with single ventricle physiology and for the other complex diagnoses, and it persisted after correction for most common risk factors for osteoporosis. Conclusion: Adults with complex CHD have reduced total body BMC and BMD compared to healthy controls. These results are a sign of frailty that conforms with other previously reported signs of premature ageing. The risk of osteoporosis is low in our relatively young population, but it is assumed to increase with ageing. We recommend that clinicians pay close attention to risk factors for osteoporosis, and are generous in administering DXA-measurements in order to prevent future fractures among adults with complex CHD.

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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Bone density, Eisenmenger complex, Heart defect, congenital, Hypoplastic left heart syndrome, Tetralogy of Fallot, Transposition of great vessels
in
International Journal of Cardiology
volume
319
pages
5 pages
publisher
Elsevier
external identifiers
  • pmid:32634489
  • scopus:85088109334
ISSN
0167-5273
DOI
10.1016/j.ijcard.2020.06.053
language
English
LU publication?
yes
id
2ae09074-c1a9-4f70-b7da-f3d3e4583665
date added to LUP
2020-07-30 13:25:39
date last changed
2024-06-26 20:13:11
@article{2ae09074-c1a9-4f70-b7da-f3d3e4583665,
  abstract     = {{<p>Aims: The majority of children with complex congenital heart disease (CHD) survive into adulthood due to advances in medical care. Adult patients with CHD have an increased incidence of diagnoses related to ageing such as heart failure, dementia, cancer and sarcopenia, despite a relatively low age. They also have a shorter life expectancy. It is unknown if their bone structures also show signs of premature ageing. We therefore investigated Bone Mineral Content (BMC) and bone mineral density (BMD) in an adult population with complex CHD. Methods: The total body BMC and BMD was examined using dual energy X-ray absorptiometry (DXA) in 73 adults with complex CHD (mean age 35.8 ± 14.3, women n = 22) and 73 age and sex matched controls. Results: The adults with complex CHD had lower total body BMC (2.6 ± 0.5 kg vs. 2.9 ± 0.5 kg, p &lt; 0.001) and BMD (1.18 ± 0.12 g/cm<sup>2</sup> vs. 1.26 ± 0.11 g/cm<sup>2</sup>, p &lt; 0.001) compared to controls. BMD was lower for patients with single ventricle physiology and for the other complex diagnoses, and it persisted after correction for most common risk factors for osteoporosis. Conclusion: Adults with complex CHD have reduced total body BMC and BMD compared to healthy controls. These results are a sign of frailty that conforms with other previously reported signs of premature ageing. The risk of osteoporosis is low in our relatively young population, but it is assumed to increase with ageing. We recommend that clinicians pay close attention to risk factors for osteoporosis, and are generous in administering DXA-measurements in order to prevent future fractures among adults with complex CHD.</p>}},
  author       = {{Sandberg, Camilla and Johansson, Karna and Christersson, Christina and Hlebowicz, Joanna and Thilén, Ulf and Johansson, Bengt}},
  issn         = {{0167-5273}},
  keywords     = {{Bone density; Eisenmenger complex; Heart defect, congenital; Hypoplastic left heart syndrome; Tetralogy of Fallot; Transposition of great vessels}},
  language     = {{eng}},
  month        = {{11}},
  pages        = {{62--66}},
  publisher    = {{Elsevier}},
  series       = {{International Journal of Cardiology}},
  title        = {{Low bone mineral density in adults with complex congenital heart disease}},
  url          = {{http://dx.doi.org/10.1016/j.ijcard.2020.06.053}},
  doi          = {{10.1016/j.ijcard.2020.06.053}},
  volume       = {{319}},
  year         = {{2020}},
}