Bone mineral density in patients on home parenteral nutrition: a follow-up study

Clin Nutr. 2004 Dec;23(6):1288-302. doi: 10.1016/j.clnu.2004.04.003.

Abstract

Background and aims: The variations of bone mineral density (BMD) during home parenteral nutrition (HPN) and their relationship with general, life style, primary disease and HPN risk factors were investigated by a follow-up study.

Design: Patients who had BMD assessment in a previous cross-sectional survey underwent a 2nd BMD at femoral neck (FN) and lumbar spine (LS). Data about risk factors were collected by a structured questionnaire. BMD Z-score (number of standard deviations from normal values corrected for sex and age) and the annualized percent BMD change were analysed.

Results: Sixty-five adult patients were enrolled (follow-up: 18.1+/-5.5 months). The mean BMD Z-score significantly increased at the LS (P = 0.040) and remained unchanged at FN. In multiple regression analysis, the variations of the LS Z-score during HPN negatively correlated with the female sex (P = 0.021) and the age at starting HPN (P = 0.022). The analysis of the annualized percent BMD change confirmed the results obtained by the analysis of the Z-score. No factor was associated with BMD variation at FN.

Conclusions: HPN was not associated with a decrease of BMD in most of the patients; LS BMD Z-score variations were related to general risk factors rather than to HPN factors, showing a negative association with age and female sex.

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Age Factors
  • Aged
  • Bone Density* / drug effects
  • Bone Diseases / epidemiology*
  • Cross-Sectional Studies
  • Female
  • Femur Neck / diagnostic imaging
  • Follow-Up Studies
  • Humans
  • Lumbar Vertebrae / diagnostic imaging
  • Male
  • Middle Aged
  • Parenteral Nutrition, Home* / adverse effects
  • Prevalence
  • Regression Analysis
  • Risk Factors
  • Sex Factors
  • Surveys and Questionnaires