Examination of Factors Affecting the Development of Osteoporosis in Children with Duchenne Muscular Dystrophy

Objective: Duchenne muscular dystrophy (DMD), which is primarily treated with glucocorticoids, is the most common genetic progressive neuromuscular disease in children, which can lead to osteoporosis and fractures. This study analyzed factors affecting osteoporosis before and after loss of ambulat...

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Main Authors: Yiğithan Güzin, Safa Mete Dağdaş, Özlem Ateş, Özkan Alataş, Ayşe Özbay Yıldız, Bakiye Tunçay, Pınar Gençpınar, Figen Baydan, Hakan Birinci, Bumin Nuri Dündar, Nihal Olgaç Dündar
Format: Article
Language:English
Published: Galenos Publishing House 2025-08-01
Series:Journal of Behçet Uz Children's Hospital
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Online Access:https://behcetuzdergisi.com/articles/examination-of-factors-affecting-the-development-of-osteoporosis-in-children-with-duchenne-muscular-dystrophy/doi/jbuch.galenos.2025.16779
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author Yiğithan Güzin
Safa Mete Dağdaş
Özlem Ateş
Özkan Alataş
Ayşe Özbay Yıldız
Bakiye Tunçay
Pınar Gençpınar
Figen Baydan
Hakan Birinci
Bumin Nuri Dündar
Nihal Olgaç Dündar
author_facet Yiğithan Güzin
Safa Mete Dağdaş
Özlem Ateş
Özkan Alataş
Ayşe Özbay Yıldız
Bakiye Tunçay
Pınar Gençpınar
Figen Baydan
Hakan Birinci
Bumin Nuri Dündar
Nihal Olgaç Dündar
author_sort Yiğithan Güzin
collection DOAJ
description Objective: Duchenne muscular dystrophy (DMD), which is primarily treated with glucocorticoids, is the most common genetic progressive neuromuscular disease in children, which can lead to osteoporosis and fractures. This study analyzed factors affecting osteoporosis before and after loss of ambulation and its relationship with fractures in DMD patients. Method: This retrospective study included 40 DMD patients. Clinical and laboratory findings and bone mineral densitometry (BMD) values were analyzed. Results: The median age at diagnosis was 3 years (Q1-Q3: 1-3.5). Osteoporosis was detected in 80% by femoral neck Z-score and 40% by vertebral Z-score, with all vertebral osteoporosis cases also meeting femoral neck osteoporosis criteria. Femoral neck Z-score worsened after loss of ambulation (p<0.05), while the lumbar Z-score remained stable. Fractures occurred in 35% of patients, with vertebral fractures in 17.5%. All vertebral fractures were associated with vertebral osteoporosis. No correlation was found between fractures and Dual-energy X-ray absorptiometry scores before loss of ambulation (p>0.05), and Z-scores were not significant predictors of fractures. The median age for glucocorticoid initiation was 48 months, with no significant difference between prednisolone and deflazacort regarding osteoporosis duration, scoliosis, or loss of ambulation (p>0.05). Scoliosis was present in 60% of patients before loss of ambulation, but no significant relationship was found between BMD and scoliosis. Conclusion: The results of this study did not show a direct correlation between BMD before the loss of ambulation and the future risk of fractures. Therefore, BMD alone may not be a sufficient predictor of scoliosis progression in DMD patients.
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series Journal of Behçet Uz Children's Hospital
spelling doaj-art-2057686f75824f7599a2a6839aa044d12025-08-20T03:40:50ZengGalenos Publishing HouseJournal of Behçet Uz Children's Hospital2822-44692025-08-011529510410.4274/jbuch.galenos.2025.16779Examination of Factors Affecting the Development of Osteoporosis in Children with Duchenne Muscular DystrophyYiğithan Güzin0https://orcid.org/0000-0002-8748-5586Safa Mete Dağdaş1https://orcid.org/0000-0001-8844-8878Özlem Ateş2https://orcid.org/0009-0001-9414-2231Özkan Alataş3https://orcid.org/0000-0003-2708-9482Ayşe Özbay Yıldız4https://orcid.org/0000-0001-6028-5990Bakiye Tunçay5https://orcid.org/0000-0003-0475-4240Pınar Gençpınar6https://orcid.org/0000-0002-3223-5408Figen Baydan7https://orcid.org/0000-0001-6853-6555Hakan Birinci8https://orcid.org/0000-0003-1369-0680Bumin Nuri Dündar9https://orcid.org/0000-0002-7506-061XNihal Olgaç Dündar10https://orcid.org/0000-0002-5902-3501University of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Pediatric Neurology, İzmir, TurkeyUniversity of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Pediatric Neurology, İzmir, TurkeyUniversity of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Pediatric Neurology, İzmir, TurkeyUniversity of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Radiology, İzmir, TurkeyUniversity of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Neuromuscular Diseases, İzmir, TurkeyUniversity of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Neuromuscular Diseases, İzmir, Turkeyİzmir Katip Çelebi University, İzmir Tepecik Training and Research Hospital, Department of Pediatric Neurology, İzmir, TurkeyUniversity of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Pediatric Neurology, İzmir, TurkeyUniversity of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Pediatric Endocrinology, İzmir, Turkeyİzmir Katip Çelebi University, İzmir Tepecik Training and Research Hospital, Department of Pediatric Endocrinology, İzmir, TurkeyUniversity of Health Sciences Turkey, İzmir Tepecik Training and Research Hospital, Clinic of Radiology, İzmir, TurkeyObjective: Duchenne muscular dystrophy (DMD), which is primarily treated with glucocorticoids, is the most common genetic progressive neuromuscular disease in children, which can lead to osteoporosis and fractures. This study analyzed factors affecting osteoporosis before and after loss of ambulation and its relationship with fractures in DMD patients. Method: This retrospective study included 40 DMD patients. Clinical and laboratory findings and bone mineral densitometry (BMD) values were analyzed. Results: The median age at diagnosis was 3 years (Q1-Q3: 1-3.5). Osteoporosis was detected in 80% by femoral neck Z-score and 40% by vertebral Z-score, with all vertebral osteoporosis cases also meeting femoral neck osteoporosis criteria. Femoral neck Z-score worsened after loss of ambulation (p<0.05), while the lumbar Z-score remained stable. Fractures occurred in 35% of patients, with vertebral fractures in 17.5%. All vertebral fractures were associated with vertebral osteoporosis. No correlation was found between fractures and Dual-energy X-ray absorptiometry scores before loss of ambulation (p>0.05), and Z-scores were not significant predictors of fractures. The median age for glucocorticoid initiation was 48 months, with no significant difference between prednisolone and deflazacort regarding osteoporosis duration, scoliosis, or loss of ambulation (p>0.05). Scoliosis was present in 60% of patients before loss of ambulation, but no significant relationship was found between BMD and scoliosis. Conclusion: The results of this study did not show a direct correlation between BMD before the loss of ambulation and the future risk of fractures. Therefore, BMD alone may not be a sufficient predictor of scoliosis progression in DMD patients.https://behcetuzdergisi.com/articles/examination-of-factors-affecting-the-development-of-osteoporosis-in-children-with-duchenne-muscular-dystrophy/doi/jbuch.galenos.2025.16779duchenne muscular dystrophybone densityosteoporosisfractures
spellingShingle Yiğithan Güzin
Safa Mete Dağdaş
Özlem Ateş
Özkan Alataş
Ayşe Özbay Yıldız
Bakiye Tunçay
Pınar Gençpınar
Figen Baydan
Hakan Birinci
Bumin Nuri Dündar
Nihal Olgaç Dündar
Examination of Factors Affecting the Development of Osteoporosis in Children with Duchenne Muscular Dystrophy
Journal of Behçet Uz Children's Hospital
duchenne muscular dystrophy
bone density
osteoporosis
fractures
title Examination of Factors Affecting the Development of Osteoporosis in Children with Duchenne Muscular Dystrophy
title_full Examination of Factors Affecting the Development of Osteoporosis in Children with Duchenne Muscular Dystrophy
title_fullStr Examination of Factors Affecting the Development of Osteoporosis in Children with Duchenne Muscular Dystrophy
title_full_unstemmed Examination of Factors Affecting the Development of Osteoporosis in Children with Duchenne Muscular Dystrophy
title_short Examination of Factors Affecting the Development of Osteoporosis in Children with Duchenne Muscular Dystrophy
title_sort examination of factors affecting the development of osteoporosis in children with duchenne muscular dystrophy
topic duchenne muscular dystrophy
bone density
osteoporosis
fractures
url https://behcetuzdergisi.com/articles/examination-of-factors-affecting-the-development-of-osteoporosis-in-children-with-duchenne-muscular-dystrophy/doi/jbuch.galenos.2025.16779
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