ABSTRACT
Bone structure and muscular strength of 30 children with renal disease were investigated by peripheral computed tomography and grip strength. Sixteen children suffered from nephrotic syndrome (NS) and had previously been treated with corticosteroids. Fourteen children suffered from chronic renal failure (CRF) ranging from mild renal failure to end-stage renal disease. Six children had received kidney transplants and corticosteroids for immunosuppression. There was a significant decrease in grip strength of children with NS (SD -0.91+/-1.5; P=0.042) and children with CRF (SD -1.38+/-1.4; P<0.001) compared with normal children. Furthermore, there was a significant correlation between cortical area and grip strength in all children with renal disease (r=0.92; P<0.0001). Trabecular bone mineral density did not correlate well with grip strength. These findings resemble results found in healthy children. Trabecular bone mineral density was significantly elevated in children with CRF compared with normal children (SD 1.14+/-1.4; P=0.008). Grip strength as a marker of muscle mass and cortical area as a marker of bone strength correlate well in children with renal disease, similar to the correlation in healthy children. Grip strength is significantly lower in children with NS and CRF compared with normal children. These data suggest that muscular impairment could be involved in renal osteopathy.
Subject(s)
Bone and Bones/diagnostic imaging , Hand Strength , Kidney Failure, Chronic/diagnostic imaging , Kidney Failure, Chronic/physiopathology , Tomography, X-Ray Computed , Adolescent , Adult , Bone Density , Child , Child, Preschool , Female , Humans , Kidney Failure, Chronic/metabolism , Male , Muscle, Skeletal/diagnostic imaging , Muscle, Skeletal/physiopathology , Nephrotic Syndrome/diagnostic imaging , Nephrotic Syndrome/metabolism , Nephrotic Syndrome/physiopathology , Reference ValuesABSTRACT
The aim of the current study is to analyze the interaction of the muscle and bone system (muscle-bone unit) during puberty in males and females by computed tomography of the nondominant forearm. The data presented here are the first results from 318 healthy children (159 boys and 159 girls), aged 6-22 yr, and 336 adults (parents) participating in the DONALD Study (Dortmund Nutritional and Anthropometric Longitudinally Designed Study). Cortical area (CA) of the radius representing bone strength and muscle area (MA) representing muscle strength were measured with peripheral quantitative computed tomography (XCT 2000; Stratec, Pforzheim, Germany). A single slice measurement at a site corresponding to 65% of the ulnar length proximal to the radial endplate was used. MA and CA of the radius have been determined by a built-in software algorithm using density differences. There was a strong correlation between MA (x) and CA (y) in all children, adolescents, and adults (y = 0.019x + 10.93; r2 = 0.77). Before puberty, boys and girls displayed a similar relation between MA and CA. CA in relation to MA was greater in girls than in boys during puberty. Analysis of covariance was performed investigating the dependency of CA on MA, five pubertal stages, sex, and interaction of sex and pubertal stages. MA representing muscle strength was the strongest predictor of CA (P < 0.001) representing bone mass. Pubertal stage (P < 0.001) and interaction of pubertal stage*sex (P = 0.002) also had a significant influence on CA. r2 of the model was 0.85. These data suggest that in pubertal girls and women rather than in pubertal boys and men an additional factor shifts the relationship between MA and CA to higher values of cortical area. The present data confirm previous studies of the influence of puberty and estrogens or related factors on the muscle-bone interaction.
Subject(s)
Bone Development/physiology , Forearm/anatomy & histology , Muscle, Skeletal/anatomy & histology , Puberty/physiology , Adolescent , Adult , Child , Cross-Sectional Studies , Female , Humans , Male , Radius/anatomy & histology , Radius/growth & development , Reference Values , Tomography, X-Ray Computed , Ulna/anatomy & histology , Ulna/growth & developmentABSTRACT
The bone mineral density (BMD) of 14 children, adolescents, and adults with phenylketonuria (PKU) on dietary treatment (age 5-28 y; 6F, 8M) was investigated using peripheral quantitative computed tomography (pQCT) of the distal radius. BMD of total (TBMD) and spongy bone (SBMD) were compared to those of healthy gender-, age-, weight- and height-matched controls. We found a significant decrease of SBMD in patients with PKU while TBMD was only slightly decreased, reaching no statistical significance. These results indicate minor changes of BMD in patients with PKU under treatment, which are more accentuated in the trabecular bone compartment. One additional patient who was untreated until the pQCT investigation at the age of 10 y also showed markedly decreased SBMD and TBMD.
