Bone mineral density in non-ambulatory adolescents with Duchenne muscular dystrophy living in Ukraine

Background. The study focuses on bone mineral density (BMD) evaluation in non-ambulatory adolescents with Du­chenne muscular dystrophy (DMD). DMD is a progressive muscle destruction, which leads to complete mobility loss and death. The pathogenic mechanisms of the disease, long-term use of glucocorticoids and progressive immobility cause the subsequent involvement of bone tissue, leading to osteopenia and secondary osteoporosis and, as a result, pathological fractures of various locations and, therefore, require prevention, early diagnosis, and treatment. The purpose was to assess bone mineral density and the frequency of osteoporosis in non-ambulatory patients with DMD. Materials and methods. Thirteen male patients aged 11–18 years with DMD from different regions of Ukraine were examined. Medical histories were reviewed for glucocorticoid treatment (including daily dose), vitamin D and calcium supplementation, the history of bone fractures and their location. Anthropometric data were collected, including height and body mass index assessment. All patients had a consultation with an endocrinologist. Bone tissue parameters were evaluated at the level of the lumbar spine, entire skeleton, right proximal femur, right femoral neck by dual-energy X-ray absorptiometry using Hologic Discovery Wi scanner. Serum levels of ionized calcium, 25(OH)D, and parathyroid hormone were also measured. Results. Eleven (84.6 %) patients had low BMD; osteoporosis was diagnosed in 38.5 % of them. 69.2 % were undergoing glucocorticoid therapy, with an average daily dose of 24.50 ± 5.38 mg. Additionally, most patients (61.5 %) had low levels of 25(OH)D. Conclusions. The high frequency of low bone mineral density among patients with Duchenne muscular dystrophy highlights the necessity for regular dual-energy X-ray absorptiometry and monitoring serum 25(OH)D levels, particularly for those on glucocorticoid therapy.