Fracture risk and impact in boys with Duchenne muscular dystrophy: A retrospective cohort study
Liaw, Joshua, Billich, Natassja, Carroll, Kate, Adams, Justine, Ryan, Monique M., Yiu, Eppie M., Zacharin, Margaret, Simm, Peter, and Davidson, Zoe E. (2023) Fracture risk and impact in boys with Duchenne muscular dystrophy: A retrospective cohort study. Muscle and Nerve, 67 (6). pp. 489-496.
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Abstract
Introduction/Aims: Boys with Duchenne muscular dystrophy (DMD) are at increased risk of fracture. This study investigated the incidence of fractures, factors contributing to risk of first fracture with emphasis on body mass index (BMI), and the impact of fractures on functional capacity in an Australian cohort of boys with DMD.
Methods: A retrospective cohort study included boys with DMD who attended a pediatric neuromuscular clinic from 2011 to 2018. Information regarding fractures, anthropometry measurements, body composition and functional assessment was collected. Factors associated with first fracture risk were analyzed with Cox-proportional hazards. Longitudinal analysis of function post-fracture was also conducted.
Results: This study included 155 boys with DMD. At least one fracture occurred in 71 (45%) boys; overall incidence of fractures was 399-per-10,000 persons-years. The first fracture was vertebral in 55%; 41% had non-vertebral fractures and 4% had both. Vertebral fractures occurred in significantly older (12.28 vs 9.28 y) boys with longer exposure to glucocorticoids (5.45 vs 2.50 y) compared to non-vertebral fractures. Boys with a history of fracture(s) had a steeper rate of functional decline (measured by Northstar Ambulatory Assessment score) than those with no recorded fractures.
Discussion: A high fracture burden was observed in a large Australian cohort of boys with DMD. Further investigation is required to understand preventative strategies and modifiable risk factors to reduce the incidence of fractures in DMD. The impact on fractures on ambulatory capacity should be closely monitored.
| Item ID: | 78264 |
|---|---|
| Item Type: | Article (Research - C1) |
| ISSN: | 1097-4598 |
| Keywords: | fractures, growth disorders, incidence, mobility, muscular dystrophy, osteoporosis, osteoporotic fractures, treatment outcome |
| Copyright Information: | This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2022 The Authors. Muscle & Nerve published by Wiley Periodicals LLC. |
| Date Deposited: | 09 May 2023 00:22 |
| FoR Codes: | 32 BIOMEDICAL AND CLINICAL SCIENCES > 3209 Neurosciences > 320905 Neurology and neuromuscular diseases @ 100% |
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