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Published ahead of print on September 11, 2002, doi:10.1164/rccm.200206-578OC

Am. J. Respir. Crit. Care Med., Volume 166, Number 11, December 2002, 1470-1474

A more recent version of this article appeared on December 1, 2002
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Submitted on June 20, 2002
Accepted on September 9, 2002

Histomorphometric analysis of bone biopsies from the iliac crest of adults with cystic fibrosis

Sarah L Elkin*, Shobna Vedi, Sharyn Bord, Nigel J Garrahan, Margaret E Hodson, and Juliet E Compston

* To whom correspondence should be addressed. E-mail: s.elkin{at}doctors.org.uk.

This study reports the results of quantitative analysis of iliac bone histology in adults with cystic fibrosis(CF) and low bone mineral density(BMD). 20 CF patients had bone biopsies taken after double tetracycline labelling. Histomorphometric measurements were made by image analysis and data were compared to those of healthy controls. Cancellous bone area was lower in the CF patients (p=0.003), and there was a trend towards a decrease in cancellous bone connectivity. Bone formation rate at tissue level was significantly lower in CF patients(p=0.0002). Wall width, representing the amount of bone formed within individual remodelling units, was decreased (p< 0.0001), as was mineralizing perimeter and mineral apposition rate. Analysis of resorption cavities revealed lower cavity area, reconstructed surface lengths, and cavity depths (p<0.003) in CF patients, whilst eroded surface area was higher (p= 0.0004). Our results demonstrate low cancellous bone volume in adult CF patients with low BMD, the main cause of which appears to be low bone formation at tissue and cellular level. Osteomalacia was diagnosed in one patient. This condition should be excluded as a cause of low bone mineral density in patients with CF and vitamin D insufficiency corrected.
Key words: bone mineral density, bone resorption, bone formation,osteomalacia




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