{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T14:24:18Z","timestamp":1794493458519,"version":"4.9.1"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T00:00:00Z","timestamp":1725235200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["#006651A123"],"award-info":[{"award-number":["#006651A123"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000897","name":"Cystic Fibrosis Foundation","doi-asserted-by":"publisher","award":["STEPHE24A0"],"award-info":[{"award-number":["STEPHE24A0"]}],"id":[{"id":"10.13039\/100000897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["P30 DK089507"],"award-info":[{"award-number":["P30 DK089507"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,11,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Improved survival in people with cystic fibrosis (pwCF) presents new complexities of care, including CF-related bone disease, a common complication in older pwCF. The trajectory of bone loss with age in this population remains unclear. The objective of this study was to estimate the average rate of change in BMD in adults with CF. This retrospective study included adults with CF, aged 25-48\u00a0yr, followed between January 2000 and December 2021. Subjects with at least one DXA scan were included. Scans obtained posttransplantation, after the initiation of bisphosphonates or cystic fibrosis transmembrane conductance regulator modulator therapy was excluded. The primary outcome was BMD (g\/cm2) at the LS and FN. A linear mixed-effects model with both random intercept and random slope terms was used to estimate the average annual change in BMD. A total of 1502 DXA scans in 500 adults (average age 28.4 y) were included. There was a statistically significant annual decline in BMD of \u22120.008 gm\/cm2\/yr (95% CI, \u22120.009 to \u22120.007) at the FN and \u22120.006 gm\/cm2\/yr (95% CI, \u22120.007 to \u22120.004) at the LS. Relative to BMD at age 25, there was a 18.8% decline at the FN by age 48\u00a0yr and a 11% decline at the LS. Pancreatic insufficient subjects had a faster rate of decline in BMD compared with pancreatic sufficient subjects. After adjusting for markers of disease severity, the annual rate of decline remained significant. Individuals with CF experience bone loss at an age when it is not anticipated, thereby entering early adulthood, where further bone loss is inevitable especially with the decrease in estrogen during menopause, with suboptimal BMD. As the CF population ages, it will become very important to consider interventions to maximize bone health.<\/jats:p>","DOI":"10.1093\/jbmr\/zjae139","type":"journal-article","created":{"date-parts":[[2024,9,2]],"date-time":"2024-09-02T08:30:24Z","timestamp":1725265824000},"page":"1716-1721","source":"Crossref","is-referenced-by-count":18,"title":["Longitudinal changes in BMD in adults with cystic fibrosis"],"prefix":"10.1093","volume":"39","author":[{"given":"Reem","family":"Jad","sequence":"first","affiliation":[{"name":"Division of Respirology , St. Michael\u2019s Hospital, , Toronto, ON M5B 1W8,","place":["Canada"]},{"name":"University of Toronto , St. Michael\u2019s Hospital, , Toronto, ON M5B 1W8,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiayi","family":"Ma","sequence":"additional","affiliation":[{"name":"Division of Respirology , St. Michael\u2019s Hospital, , Toronto, ON M5B 1W8,","place":["Canada"]},{"name":"University of Toronto , St. Michael\u2019s Hospital, , Toronto, ON M5B 1W8,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanja","family":"Stanojevic","sequence":"additional","affiliation":[{"name":"Department of Community Health and Epidemiology, Dalhousie University , Halifax, NS B3H 1V7,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abarnaa","family":"Illango","sequence":"additional","affiliation":[{"name":"Division of Respirology , St. Michael\u2019s Hospital, , Toronto, ON M5B 1W8,","place":["Canada"]},{"name":"University of Toronto , St. Michael\u2019s Hospital, , Toronto, ON M5B 1W8,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Tullis","sequence":"additional","affiliation":[{"name":"Division of Respirology , St. Michael\u2019s Hospital, , Toronto, ON M5B 1W8,","place":["Canada"]},{"name":"University of Toronto , St. Michael\u2019s Hospital, , Toronto, ON M5B 1W8,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Gilmour","sequence":"additional","affiliation":[{"name":"Division of Endocrinology , St. Michael\u2019s Hospital, , Toronto, ON M5B 1W8,","place":["Canada"]},{"name":"University of Toronto , St. Michael\u2019s Hospital, , Toronto, ON M5B 1W8,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher H","family":"Goss","sequence":"additional","affiliation":[{"name":"Division of Pulmonary , Critical Care and Sleep Medicine, Department of Medicine, , Seattle, WA 98195,","place":["United States"]},{"name":"University of Washington , Critical Care and Sleep Medicine, Department of Medicine, , Seattle, WA 98195,","place":["United States"]},{"name":"Division of Pulmonology , Department of Pediatrics, , Seattle, WA 98195,","place":["United States"]},{"name":"University of Washington , Department of Pediatrics, , Seattle, WA 98195,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa J","family":"Strug","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children, University of Toronto , Toronto, ON M5G 1X8,","place":["Canada"]},{"name":"Departments of Statistical Sciences and Computer Science, University of Toronto , Toronto, ON M5G 1Z5,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4529-5653","authenticated-orcid":false,"given":"Anne L","family":"Stephenson","sequence":"additional","affiliation":[{"name":"Division of Respirology , St. Michael\u2019s Hospital, , Toronto, ON M5B 1W8,","place":["Canada"]},{"name":"University of Toronto , St. Michael\u2019s Hospital, , Toronto, ON M5B 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