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Bone microarchitectural alterations in boys with Duchenne muscular dystrophy on long-term glucocorticoid treatment

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Abstract

Introduction

Osteoporosis is a major health issue in boys with Duchenne muscular dystrophy (DMD). Data on the specific bone deficits and microarchitectural alterations in children with DMD were limited. This study aimed to assess the bone microarchitectural alterations in boys with DMD on long-term glucocorticoid using high-resolution peripheral quantitative computed tomography (HR-pQCT).

Materials and methods

This was a cross-sectional, case–control study. Boys with DMD older than 5 years with no prior history of symptomatic fracture and had been on long-term glucocorticoid treatment were recruited from a single tertiary centre. For each participant, three gender- and age-matched controls were selected randomly from an existing HR-pQCT database of healthy individuals.

Results

Nine boys with DMD at a median age of 9.3 years were included. Three were found to have asymptomatic vertebral compression fracture. The HR-pQCT findings of these nine boys were compared with 27 healthy controls. Trabecular microstructure indices at the distal radius were significantly lower but the cortical vBMD was significantly higher in the DMD boys when compared with healthy controls.

Conclusion

Lower microarchitectural measurement of trabecular bones, but higher cortical vBMD, was observed in DMD boys on long-term oral glucocorticoid. The results from this study provide preliminary, yet important insights into the bone microarchitecture of this group of patients.

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Acknowledgements

The authors would like to thank all the patients and families for participating in this study.

Author information

Authors and Affiliations

  1. Department of Paediatrics, Hong Kong Children’s Hospital, 1 Shing Cheong Road, Kowloon Bay, Kowloon, Hong Kong

    Joanna Yuet-ling Tung

  2. SH Ho Scoliosis Research Lab, Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Nanjing, China

    Tsz-ping Lam

  3. Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong

    Tsz-ping Lam

  4. Department of Paediatrics & Adolescent Medicine, Queen Mary Hospital, LKS Faculty of Medicine, The University of Hong Kong, Shatin, Hong Kong

    Joanna Yuet-ling Tung & Sophelia Hoi-shan Chan

Authors
  1. Joanna Yuet-ling Tung
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  2. Tsz-ping Lam
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  3. Sophelia Hoi-shan Chan
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Contributions

JYT contributed in study design, recruitment of subjects, data analysis and manuscript preparation. SHC contributed to the study design, recruitment of subjects and interpretations of data. TPL contributed to the HR-pQCT scanning protocols and interpretations of DXA and HR-pQCT findings. All authors contributed to interpretation of findings and critically revised the manuscript and approved the final version of the manuscript for submission.

Corresponding author

Correspondence to Joanna Yuet-ling Tung.

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Tung, J.Yl., Lam, Tp. & Chan, S.Hs. Bone microarchitectural alterations in boys with Duchenne muscular dystrophy on long-term glucocorticoid treatment. J Bone Miner Metab 39, 606–611 (2021). https://doi.org/10.1007/s00774-020-01196-w

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  • DOI: https://doi.org/10.1007/s00774-020-01196-w

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