Autonomic dysfunction and osteoporosis after electrical burn

Abstract

IntroductionSeveral studies have shown the importance of the sympathetic nervous system in bone metabolism. There is an evidence of sympathetic skin response (SSR) impairment in electrical burn patients up to 2 years after their injuries. The acute phase of burn is accompanied by increased bone resorption. Whether the prolonged dysfunction of sympathetic nervous system may result in bone metabolism derangement even after the acute phase of electrical burn is the inspiring question for this study. And we tried to find correlation between SSR abnormality and areal bone mineral density (BMD) in electrical burn patients 6 months or more after the incidents. Methods and materials42 electrical burn patients (≥6 months prior to study) who did not have a known joint or bone disease, history of neuropathy (central or peripheral), diabetes mellitus or consumption of any drug affecting the autonomic nervous system or evidence of neuropathy in nerve conduction study were recruited. We also gathered a control group of 50 healthy subjects (without electrical burn or the exclusion criteria). They went under dual energy X-ray absorptiometry and SSR study. Data were analyzed statistically with SPSS 16.0 making use of independent t-test and Pearson correlation coefficient. P<0.05 was considered significant statistically. ResultsAreal BMD was significantly lower in electrical burn patients than control group (P<0.001). SSR latency was significantly prolonged and its amplitude was significantly reduced in burn patients compared to control group (P<0.001). In burn patients there was an inverse correlation of areal BMD of lumbar vertebrae, left femur neck and total femur with SSR latency and a direct correlation of areal BMD with SSR amplitude. In control group there was just direct correlation of areal BMD of lumbar vertebrae and left femur neck with SSR amplitude. ConclusionElectrical burn patients are at risk of reduced areal BMD long after their injuries. Sympathetic derangement and impaired SSR are correlated with reduction in areal BMD in these patients.