Evaluation of bone health in patients with mucopolysaccharidosis

KOR D., BULUT F. D., Kilavuz S., Yilmaz B. S., Koseci B., KARA E., ...More

JOURNAL OF BONE AND MINERAL METABOLISM, vol.40, pp.498-507, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 40
  • Publication Date: 2022
  • Doi Number: 10.1007/s00774-021-01304-4
  • Journal Name: JOURNAL OF BONE AND MINERAL METABOLISM
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.498-507
  • Keywords: Mucopolysaccharidosis, 25(OH)D-3, Bone mineral density, Skeletal system, Dysostosis multiplex, VITAMIN-D LEVELS, MINERAL DENSITY, CHILDREN, MASS
  • Çukurova University Affiliated: Yes

Abstract

Introduction This study aimed to evaluate the relationship between clinical findings, height and weight standard deviation scores, 25-hydroxyvitamin D-3 (25(OH)D-3) level, and dual-energy X-ray absorptiometry (DXA) results in patients diagnosed with mucopolysaccharidosis (MPS), where effective current treatments such as enzyme replacement therapy (ERT) can be accessed. Materials and methods 25(OH)D-3 level was measured in 126 patients with MPS (17 with MPS I, 14 with MPS II, 18 with MPS III, 33 with MPS IVA, and 44 with MPS VI; 24-524 months). DXA was performed in 45 of these patients (8 with MPS I, 4 with MPS II, 4 with MPS III, 12 with MPS IVA, and 17 with MPS VI; 62-197 months; all patients were under 18 when DXA was performed) to assess bone mineral density (BMD) of the lumbar spine. Results In total, 67.5% patients had a short stature, and 50% of them were underweight for their age. Of the patients, 13.5% were immobile, 28.6% had 25(OH)D-3 deficiency, and 30.2% had an insufficient level of 25(OH)D-3. BMD z score of 45 patients was - 2.5 +/- 1.7. In 40% patients, it was < - 2. However, after correction for height-for-age z score (HAZ), HAZ-adjusted BMD z score was - 0.1 +/- 0.9. In 2.2% patients, it was < - 2. Conclusion The low BMD z score prevalence reported with DXA was misleadingly higher in children with MPS and short stature. To prevent exposure to unnecessary antiresorptive treatments in these children, the effect of severe short stature and bone geometry on DXA measurements should be considered; further studies on bone health are warranted.