Abstract

BackroundOsteogenesis imperfecta(OI) is a frequent bone fragility disorder in children. The purpose of this study was to assess the BMD and Vitamin D level in children with OI in southern Iran.MethodThis case-control study was conducted on 23 children, clinically diagnosed as osteogenesis imperfecta and 23 age- and gender-matched healthy controls. Demographic and anthropometric data, biochemical parameters, puberty, sun exposure and physical activity were assessed. Bone mineral density (BMD) was measured by Dual-energy X-ray absorptiometry (DXA). Data analysis was done by SPSS22.ResultsForty-three point four percent of OI patients and fifty-six point five percent of control group had vitamin D deficiency (P = 0.376). Thirteen OI patients (56%) had low bone mass for chronological age in lumbar area (P < 0.001). Fracture episodes during treatment was significantly influenced by time of Pamidronate start, courses of Pamidronate injection, puberty and sun exposure (P values = 0.015, 0.030, 0.044 and 0.032, respectively). Fracture episodes during treatment had significantly increased in patients who had received Pamidronate more than 3 years compared with those received less than 3 years(P values = 0.047).ConclusionsThis study showed that vitamin D deficiency is prevalent amongst OI children in southern Iran. More than half of the OI children had low bone mass for chronological age in lumbar area, despite receiving bisphosphonate therapy. The present results revealed that early initiation of Pamidronate and number of Pamidronate courses are associated with lower fracture rate. However, treatment period more than 3 years can have adverse effect on fracture rates.

Highlights

  • Osteogenesis imperfecta(OI), or brittle bone disease, is one of the most common primary bone fragility disorder in children and adolescents

  • This study showed that vitamin D deficiency is prevalent amongst OI children in southern Iran

  • The present results revealed that early initiation of Pamidronate and number of Pamidronate courses are associated with lower fracture rate

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Summary

Introduction

Osteogenesis imperfecta(OI), or brittle bone disease, is one of the most common primary bone fragility disorder in children and adolescents. Diagnosis is based on history, clinical findings and radiographic findings of repeated old and new fractures which showed no criteria of other metabolic bone disease. Extra-skeletal manifestations consist in blue sclera, dentinogenesis imperfecta, and hearing impairment [2, 3]. OI has been categorized, according to clinical presentation into four types(types I– IV), based on Sillence criteria [4]. This criteria was introduced in 1979 according to clinical and radiological findings and mode of inheritance, prior to the availability of molecular genetic analyses. Clinical OI types II, III, and IV have either autosomal or recessive inheritance

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