{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T15:42:29Z","timestamp":1760888549819},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2011,9,1]],"date-time":"2011-09-01T00:00:00Z","timestamp":1314835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objectives:<\/jats:title><jats:p>The aim of the study was to examine the association of corticosteroid exposure and other skeletal risk factors with bone mineral density (BMD) and fractures following pediatric liver transplantation (LT) at a large single center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods:<\/jats:title><jats:p>Lumbar spine BMD, measured using dual\u2010energy x\u2010ray absorptiometry (DXA), was corrected for bone age in 52 ambulatory children ages 4 to 18 years, at least 1 year post\u2010LT. Potential risk factors for skeletal health such as corticosteroid exposure, dietary and lifestyle factors, and growth and fracture occurrence, were related to BMD using univariate and multivariate regression analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>The prevalence of low BMD (<jats:italic>z<\/jats:italic> score &lt;\u22122) and post\u2010LT fractures was 3 of 52 (5.8%) and 11 of 52 (21%), respectively. Univariate analysis revealed age &gt;10 years at LT and body mass index (BMI) &lt;85th percentile at time of DXA were significantly associated with BMD (both <jats:italic>P<\/jats:italic> = 0.02). BMD did not correlate with corticosteroid dosage in the first year post\u2010LT, the year before DXA or cumulative lifetime exposure. A cholestatic primary LT indication, acute rejection episodes, and fractures post\u2010LT were not associated with BMD. Extracurricular physical activity, vitamin D, and calcium intake were not associated with BMD or fractures. Multivariate linear regression revealed increased time post\u2010LT (<jats:italic>P<\/jats:italic> = 0.04) and higher BMI <jats:italic>z<\/jats:italic> score at time of DXA (<jats:italic>P<\/jats:italic> = 0.02) as the strongest independent variables associated with greater BMD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>Neither corticosteroid exposure nor a cholestatic primary indication for LT influenced BMD, which was largely normal in this ambulatory group. Children and adolescents undergoing LT after the age of 10 years and those with low BMI post\u2010LT may be at greatest risk of poor skeletal health later in life, and thus a potential target patient population to benefit from preventive interventions.<\/jats:p><\/jats:sec>","DOI":"10.1097\/mpg.0b013e3182258656","type":"journal-article","created":{"date-parts":[[2011,6,1]],"date-time":"2011-06-01T07:40:36Z","timestamp":1306914036000},"page":"326-332","source":"Crossref","is-referenced-by-count":14,"title":["Corticosteroid Exposure Not Associated With Long\u2010term Bone Mineral Density in Pediatric Liver Transplantation"],"prefix":"10.1002","volume":"53","author":[{"given":"Scott","family":"Nightingale","sequence":"first","affiliation":[{"name":"SickKids Transplant Centre the Hospital for Sick Children University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona D.","family":"McEwan\u2010Jackson","sequence":"additional","affiliation":[{"name":"SickKids Transplant Centre the Hospital for Sick Children University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gillian A.","family":"Hawker","sequence":"additional","affiliation":[{"name":"Osteoporosis Research Program Women's College Ambulatory Care Center University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"Macarthur","sequence":"additional","affiliation":[{"name":"Bloorview Research Institute Bloorview Kids Rehab University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amina Z.","family":"Khambalia","sequence":"additional","affiliation":[{"name":"Paediatric Outcomes Research Team the Hospital for Sick Children University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisha","family":"Lo","sequence":"additional","affiliation":[{"name":"SickKids Transplant Centre the Hospital for Sick Children University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annie","family":"Fecteau","sequence":"additional","affiliation":[{"name":"SickKids Transplant Centre the Hospital for Sick Children University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vicky L.","family":"Ng","sequence":"additional","affiliation":[{"name":"SickKids Transplant Centre the Hospital for Sick Children University of Toronto Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,9]]},"reference":[{"key":"e_1_2_7_2_1","volume-title":"Organ Procurement and Transplantation Network and the Scientific Registry of Transplant Recipients: Transplant Data 1998\u20102007","author":"US Department of Health and Human Services, Health Resources and Services Administration, Healthcare Systems Bureau, Division of Transplantation.","year":"2008"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008-1363"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2008.02432.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1359\/JBMR.051107"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.75.4.1060"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8529(02)00058-0"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1359\/jbmr.060601"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1053\/jlts.2001.50038"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-200206150-00015"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/jlts.2003.50071"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2007.02015.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.TP.0000136987.38729.C0"},{"key":"e_1_2_7_14_1","unstructured":"U.S. Department of Agriculture Agricultural Research Service Nutrient Data Laboratory.USDA National Nutrient Database for Standard Reference Release 22http:\/\/www.ars.usda.gov\/ba\/bhnrc\/ndl. 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