Endocrine Abstracts

JOINT3310

A high risk of fractures was reported in a patient with duchenne muscular dystrophy (DMD) which could be due to inmobilization, the pathophysiology of the disease, treatment with glucorticoids (GCs) and increased BMI. Knowledge of the risk factors for the disease contributes to creating preventive strategies that reduce co-morbidities and improve the quality of life in these patients.

Objetive: To assess the incidence of first fractures and factors contributing to risk of first fracture in children with DMD

Methods: A retrospective analysis of a cohort of patients with Duchenne Muscular was carried out A total of 27 children under 18 years of age with clinical and molecular diagnosis of DMD were enrolled. The study was approved by the ethics committee and all procedures were performed following the Declaration of Helsinki. The study began in 2010, a total of 27 children were referred to our endocrinology service for their evaluation. Anthropometric variables were evaluated at the start of the study and during follow-up. In addition, annual spine radiographs were performed. Data on long bone (LBF) and vertebral fractures (VF) were recorded. Questionnaires about calcium intake and mobility were also administered. The variables are summarized in mean (SD), median (IQR) and percentage according to their nature.

Results: The age of DMD diagnosis was 6.52±2.83y and the follow-up time was 7.77 (±4.57y). Age of starting GCs was 8.12±2.45y and average daily was 0.6±0.12 mg/k/d. 7 children with new fractures (VF or LBF) were observed during this period, median time 5.07 (RIQ 3-6.66y). Cumulative incidences was 0.26 or 26%. Children with fractures presented a delay in the age of diagnosis (8 vs 5.5 y) and increased BMI (P = 0.01). No differences were observed in biochemical markers, vitamin D, time and dose of corticosteroids between fractured and non-fractured.

Conclusion: We observed a high incidence of fractures in this population, which highlights the importance of a multidisciplinary approach and the creation of strategies to reduce modifiable risk factors to improve the quality of life of these children. BMI could be a risk factor to take into account when considering treatment strategies in these patients.