Long-term reduction in bone mass after severe burn injury in children

Gordon L. Klein, David Herndon, Craig B. Langman, Thomas C. Rutan, William E. Young, Gregory Pembleton, Martin Nusynowitz, Joseph L. Barnett, Lyle D. Broemeling, Dawn E. Sailer, Robert L. McCauley

Research output: Contribution to journalArticle

112 Citations (Scopus)

Abstract

Objective: Because burn victims are at risk of having bone loss, a cross-sectional study was undertaken to determine whether severe burn injury had acute and long-term effects on bone mass or on the incidence of fractures in children. Methods: Dual-energy x-ray absorptiometry of the lumbar portion of the spine was performed on 68 children: 16 moderately burned (15% to 36% of total body surface area) and 52 age-matched severely burned (≥40% of total body surface area). Twenty-two severely burned children were hospitalized and studied within 8 weeks of their burn, and 30 others were studied approximately 5 years after discharge. In the severely burned group, both hospitalized and discharged, serum and urine were analyzed for calcium, phosphorus, intact parathyroid hormone, osteocalcin, and type I collagen telopeptide. Results: Sixty percent of severely burned patients had age-related z scores for bone density less than -1, and 27% of severely burned patients had age-related z scores for bone density less than -2 (p <0.005, for each). In the moderately burned group, 31% of patients had z scores less than -1 (p <0.005 vs normal distribution), but only 6% had z scores less than -2 (p value not significant). There was evidence of increased incidence of fractures after discharge in the severely burned patients. Biochemical studies were compatible with a reduction in bone formation and an increase in resorption initially, and with a long-term persistence of low formation. Conclusion: We conclude that acute burn injury leads to profound and long-term bone loss, which may adversely affect peak bone mass accumulation. (J PEDIATR 1995;126:252-6).

Original languageEnglish (US)
Pages (from-to)252-256
Number of pages5
JournalThe Journal of pediatrics
Volume126
Issue number2
DOIs
StatePublished - 1995
Externally publishedYes

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Bone and Bones
Body Surface Area
Wounds and Injuries
Bone Density
Hospitalized Child
Normal Distribution
Osteocalcin
Incidence
Collagen Type I
Parathyroid Hormone
Osteogenesis
Phosphorus
Spine
Cross-Sectional Studies
X-Rays
Urine
Calcium
Serum

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Klein, G. L., Herndon, D., Langman, C. B., Rutan, T. C., Young, W. E., Pembleton, G., ... McCauley, R. L. (1995). Long-term reduction in bone mass after severe burn injury in children. The Journal of pediatrics, 126(2), 252-256. https://doi.org/10.1016/S0022-3476(95)70553-8

Long-term reduction in bone mass after severe burn injury in children. / Klein, Gordon L.; Herndon, David; Langman, Craig B.; Rutan, Thomas C.; Young, William E.; Pembleton, Gregory; Nusynowitz, Martin; Barnett, Joseph L.; Broemeling, Lyle D.; Sailer, Dawn E.; McCauley, Robert L.

In: The Journal of pediatrics, Vol. 126, No. 2, 1995, p. 252-256.

Research output: Contribution to journalArticle

Klein, GL, Herndon, D, Langman, CB, Rutan, TC, Young, WE, Pembleton, G, Nusynowitz, M, Barnett, JL, Broemeling, LD, Sailer, DE & McCauley, RL 1995, 'Long-term reduction in bone mass after severe burn injury in children', The Journal of pediatrics, vol. 126, no. 2, pp. 252-256. https://doi.org/10.1016/S0022-3476(95)70553-8
Klein GL, Herndon D, Langman CB, Rutan TC, Young WE, Pembleton G et al. Long-term reduction in bone mass after severe burn injury in children. The Journal of pediatrics. 1995;126(2):252-256. https://doi.org/10.1016/S0022-3476(95)70553-8
Klein, Gordon L. ; Herndon, David ; Langman, Craig B. ; Rutan, Thomas C. ; Young, William E. ; Pembleton, Gregory ; Nusynowitz, Martin ; Barnett, Joseph L. ; Broemeling, Lyle D. ; Sailer, Dawn E. ; McCauley, Robert L. / Long-term reduction in bone mass after severe burn injury in children. In: The Journal of pediatrics. 1995 ; Vol. 126, No. 2. pp. 252-256.
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abstract = "Objective: Because burn victims are at risk of having bone loss, a cross-sectional study was undertaken to determine whether severe burn injury had acute and long-term effects on bone mass or on the incidence of fractures in children. Methods: Dual-energy x-ray absorptiometry of the lumbar portion of the spine was performed on 68 children: 16 moderately burned (15{\%} to 36{\%} of total body surface area) and 52 age-matched severely burned (≥40{\%} of total body surface area). Twenty-two severely burned children were hospitalized and studied within 8 weeks of their burn, and 30 others were studied approximately 5 years after discharge. In the severely burned group, both hospitalized and discharged, serum and urine were analyzed for calcium, phosphorus, intact parathyroid hormone, osteocalcin, and type I collagen telopeptide. Results: Sixty percent of severely burned patients had age-related z scores for bone density less than -1, and 27{\%} of severely burned patients had age-related z scores for bone density less than -2 (p <0.005, for each). In the moderately burned group, 31{\%} of patients had z scores less than -1 (p <0.005 vs normal distribution), but only 6{\%} had z scores less than -2 (p value not significant). There was evidence of increased incidence of fractures after discharge in the severely burned patients. Biochemical studies were compatible with a reduction in bone formation and an increase in resorption initially, and with a long-term persistence of low formation. Conclusion: We conclude that acute burn injury leads to profound and long-term bone loss, which may adversely affect peak bone mass accumulation. (J PEDIATR 1995;126:252-6).",
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AU - Pembleton, Gregory

AU - Nusynowitz, Martin

AU - Barnett, Joseph L.

AU - Broemeling, Lyle D.

AU - Sailer, Dawn E.

AU - McCauley, Robert L.

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N2 - Objective: Because burn victims are at risk of having bone loss, a cross-sectional study was undertaken to determine whether severe burn injury had acute and long-term effects on bone mass or on the incidence of fractures in children. Methods: Dual-energy x-ray absorptiometry of the lumbar portion of the spine was performed on 68 children: 16 moderately burned (15% to 36% of total body surface area) and 52 age-matched severely burned (≥40% of total body surface area). Twenty-two severely burned children were hospitalized and studied within 8 weeks of their burn, and 30 others were studied approximately 5 years after discharge. In the severely burned group, both hospitalized and discharged, serum and urine were analyzed for calcium, phosphorus, intact parathyroid hormone, osteocalcin, and type I collagen telopeptide. Results: Sixty percent of severely burned patients had age-related z scores for bone density less than -1, and 27% of severely burned patients had age-related z scores for bone density less than -2 (p <0.005, for each). In the moderately burned group, 31% of patients had z scores less than -1 (p <0.005 vs normal distribution), but only 6% had z scores less than -2 (p value not significant). There was evidence of increased incidence of fractures after discharge in the severely burned patients. Biochemical studies were compatible with a reduction in bone formation and an increase in resorption initially, and with a long-term persistence of low formation. Conclusion: We conclude that acute burn injury leads to profound and long-term bone loss, which may adversely affect peak bone mass accumulation. (J PEDIATR 1995;126:252-6).

AB - Objective: Because burn victims are at risk of having bone loss, a cross-sectional study was undertaken to determine whether severe burn injury had acute and long-term effects on bone mass or on the incidence of fractures in children. Methods: Dual-energy x-ray absorptiometry of the lumbar portion of the spine was performed on 68 children: 16 moderately burned (15% to 36% of total body surface area) and 52 age-matched severely burned (≥40% of total body surface area). Twenty-two severely burned children were hospitalized and studied within 8 weeks of their burn, and 30 others were studied approximately 5 years after discharge. In the severely burned group, both hospitalized and discharged, serum and urine were analyzed for calcium, phosphorus, intact parathyroid hormone, osteocalcin, and type I collagen telopeptide. Results: Sixty percent of severely burned patients had age-related z scores for bone density less than -1, and 27% of severely burned patients had age-related z scores for bone density less than -2 (p <0.005, for each). In the moderately burned group, 31% of patients had z scores less than -1 (p <0.005 vs normal distribution), but only 6% had z scores less than -2 (p value not significant). There was evidence of increased incidence of fractures after discharge in the severely burned patients. Biochemical studies were compatible with a reduction in bone formation and an increase in resorption initially, and with a long-term persistence of low formation. Conclusion: We conclude that acute burn injury leads to profound and long-term bone loss, which may adversely affect peak bone mass accumulation. (J PEDIATR 1995;126:252-6).

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