Bone mineral density in adolescent urinary stone formers: is sex important?

Bone mineral density in adolescent urinary stone formers: is sex important?

Kusumi Kirsten; Schwaderer Andrew L; Clark Curtis; Budge Kevin; Hussein Nazar; Raina Rupesh; Denburg Michelle; Safadi Fayez F

Urolithiasis

2020

2020-03-31

Urinary stone disease (USD) is affecting a greater number of children and low bone mineral density (BMD) and increased skeletal fractures have been demonstrated in stone patients; however, the mechanism(s) driving bone disease remain unclear. This pilot study was undertaken to assess an adolescent kidney stone cohort's BMD and evaluate for an inverse correlation between BMD and urine concentration of lithogenic minerals and/or inflammatory levels. Prospective case-control study was carried out at a large pediatric center. 15 participants with USD (12-18 years of age, 8 female) were matched by age, sex, and body mass index to 15 controls. Lumbar and total body BMD z-score did not differ between groups. When stone formers were separated by sex, there was a significant difference between male stone formers vs. controls total body BMD z-score (Fig. 1). BMD z-score did not significantly correlate with urine calcium, oxalate, citrate or magnesium. Higher urine IL-13 did significantly correlate with higher total body BMD z-score (r = 0.677, p = 0.018). Total body BMD z-score did significantly correlate with body mass index (BMI) as expected for the control group (r = 0.6321, p = 0.0133). However, this relationship was not present in the USD group (r = - 0.1629, p = 0.5619). This is a small but hypothesis-generating study which demonstrates novel evidence of male-specific low BMD in adolescent stone formers. Furthermore, we demonstrated a positive association between urine

Bone; children; disease; fracture; health; inflammation; kidney-stones; nephrolithiasis; osteoporosis; Pediatrics; risk; Sex; Urolithiasis; Urolithiasis

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journalArticle

2194-7236 2194-7228

NEOMED College of Medicine

Department of Pediatrics; Department of Anatomy & Neurobiology

June 2020 Update I

Akron Children's Hospital