What is osteoporosis?
Osteoporosis occurs when bones become thin and brittle. Although it occurs mainly in older people, CF patients are at an increased risk of osteoporosis, too, making them prone to fractures. That's why preventing osteoporosis is so important for CF patients.
Why do people with CF develop osteoporosis?
In CF patients, low levels of vitamin D resulting from malabsorption impair the formation of bone. CF patients who do not get enough exposure to sunlight, which converts vitamin D into its active form, also may be prone to osteoporosis. Bone breakdown is related to inactivity, malnutrition, chronic lung disease, and steroid use. Patients with recurrent pulmonary exacerbations are at a high risk of developing osteoporosis. Lung transplant recipients have an accelerated rate of bone loss related to use of immunosuppressive drugs such as corticosteroids. Men are more often affected than women, which scientists believe is related to low sex hormone levels important to bone development, and to delayed onset of puberty. Diabetes, alcohol use, and cigarette smoking may also hasten the onset of osteoporosis.
How do you detect osteoporosis?
CF patients over 18 years old should be screened every other year for osteoporosis with a DEXA (Dual-energy radiograph absorptiometry) scan. Bone density is measured at the spine, upper leg, or other site with two X-ray scans. The test is painless and takes only a few minutes to perform. Results may show early osteoporosis or the full onset of the disease. Patients should also have serum vitamin D levels checked yearly along with diabetes screening.
|Dr. Michael Boyle supervises a patient getting a bone density (DEXA) scan.|
How is CF osteoporosis treated?
CF osteoporosis is treated by eating a healthy diet and paying special attention to vitamin D and calcium intake. Sunlight helps bone health by increasing active amounts of vitamin D. Exercise helps to strengthen bones as well. Depending on the severity of the disease, your physician may prescribe biosphosphonates, which encourage bone growth.
Can CF osteoporosis be prevented?
Preventing osteoporosis is very similar to the way it is treated. Your risk of osteoporosis can be reduced by—
Getting plenty of exercise to build strong bones.
Eating a healthy diet, especially calcium and vitamin D.
Getting enough sunlight to help your body make the vitamin D needed to build strong bones.