Risk factors associated with prevalent vertebral fractures in Duchenne muscular dystrophy
Authors' conclusion
Readily measurable clinical variables were associated with prevalent VF in males with glucocorticoid-treated DMD.
Study context
- Population
- Males aged 4–25 years with Duchenne muscular dystrophy (DMD)mean age 11.5 years
- Participants
- 60 males
- Exposure
- Participants with vertebral fractures (VF) vs without VF
- VFn = 19
- Outcome
- Clinical factors associated with prevalent VF (Spinal Deformity Index, SDI, the sum of the Genant grades)
Methodological detailsmultivariable Poisson regression
- Multivariable Poisson regression
Main finding
As reported in the abstract
Prevalent VF
- Participants with VF
- 19 (32%)
- Total VF
- 67
- Moderate or severe VF
- 23/67 (34%)
- Spinal Deformity Index (SDI) increase per 0.1 mg/kg/day increment in average GC daily dose (multivariable Poisson regression), 1.4-fold, 95% CI 1.1-1.7
- p = 0.013
- Greater bone age (BA) delay associated with SDI increase
- p < 0.001
- Higher weight Z-score associated with SDI increase
- p = 0.004
- Decreased height Z-score associated with SDI increase
- p = 0.025
- Lower LSvBMD Z-score associated with SDI increase
- p = 0.025
Observational data: associations, not effects.
Further findings
GC exposure duration
P = 0.027
| Outcome | VF | No VF | P value |
|---|---|---|---|
| Height Z-scoreMean - | 3.1 (SD 1.4) | 1.8 (SD 1.4) | P = 0.001 |
| BA to chronological age differenceMean -, years | 3.2 (SD 3.4) | 1.3 (SD 1.2) | P = 0.035 |
| LSaBMD Z-scoreMean - | 3.0 (SD 1.0) | 2.2 (SD 1.2) | P = 0.023 |
LSvBMD Z-score
- No difference in LSvBMD Z-scores
Original publication
Risk factors associated with prevalent vertebral fractures in Duchenne muscular dystrophy. Osteoporos Int. Published 7 November 2022. doi:10. 1007/ s00198-022-06578-6
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