A Roadmap to the Brittle Bones of Cystic Fibrosis

Table 1

Causes of decreased bone density in cystic fibrosis.

(i) Pancreatic insufficiency
(ii) Malnutrition and poor growth
(iii) Vitamin D, vitamin K, and calcium insufficiency
(iv) CF-related diabetes
(v) Glucocorticoids
(vi) Sex steroid deficiency and delayed puberty
(vii) Chronic inflammation
(viii) Tobacco, alcohol, and caffeine use
(ix) Moderate to severe lung disease
(x) Lack of exercise, especially weight bearing
(xi) Organ transplant and immunosuppressive therapy
(xii) Medications (Depo-Provera, Megestrol Acetate, and Aluminium containing-antiacids)
(xiii) Possible role of CFTR.