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Changes in bone mineral density and body composition of children with well-controlled homocystinuria caused by CBS deficiency

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Abstract

Homocystinuria due to cystathionine β-synthase (CBS) deficiency is an inherited disorder of the metabolism of methionine. Clinical manifestations include mental retardation, dislocation of the optic lens, vascular lesions, arterial and venous thromboembolism, skeletal abnormalities, and osteoporosis. Most homocystinuria patients diagnosed in adulthood have severe osteoporosis, and homocystinuria is frequently mentioned as a cause of osteoporosis. Good control of plasma homocysteine may prevent or delay some of these complications. However, the effectiveness of bone mineral density (BMD) gain or fracture prevention has not been addressed. Here, we describe changes in BMD and body composition in 5 CBS deficiency patients who were diagnosed at young age and were managed with good metabolic control. We found that the BMD of each region was within the normal range. BMD gain was adequate and the patients had no significant change in skeletal morphology.

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References

  1. Picker JD, Levy HL. Homocystinuria Caused by Cystathionine Beta-Synthase Deficiency. 2004 Jan 15 [updated 2011 Apr 26]. GeneReviews™ [Internet]. Seattle (WA): University of Washington, Seattle; 1993-. Available from http://www.ncbi.nlm.nih.gov/books/NBK1524/

  2. Mudd SH, Skovby F, Levy HL, Pettigrew KD, Wilcken B, Pyeritz RE, Andria G, Boers GH, Bromberg IL, Cerone R (1985) The natural history of homocystinuria due to cystathionine beta-synthase deficiency. Am J Hum Genet 37:1–31

    PubMed  CAS  Google Scholar 

  3. Yap S, Naughten E (1998) Homocystinuria due to cystathionine beta-synthase deficiency in Ireland: 25 years’ experience of a newborn screened and treated population with reference to clinical outcome and biochemical control. J Inherit Metab Dis 21:738–747

    Article  PubMed  CAS  Google Scholar 

  4. Parrot F, Redonnet-Vernhet I, Lacombe D, Gin H (2000) Osteoporosis in late-diagnosed adult homocystinuric patients. J Inherit Metab Dis 23:338–340

    Article  PubMed  CAS  Google Scholar 

  5. Mulvihill A, Yap S, O’Keefe M, Howard PM, Naughten ER (2001) Ocular findings among patients with late-diagnosed or poorly controlled homocystinuria compared with a screened, well-controlled population. J AAPOS 5:311–315

    Article  PubMed  CAS  Google Scholar 

  6. Topaloglu AK, Sansaricq C, Snyderman SE (2001) Influence of metabolic control on growth in homocystinuria due to cystathionine B-synthase deficiency. Pediatr Res 49:796–798

    Article  PubMed  CAS  Google Scholar 

  7. Yap S, Rushe H, Howard PM, Naughten ER (2001) The intellectual abilities of early-treated individuals with pyridoxine-nonresponsive homocystinuria due to cystathionine beta-synthase deficiency. J Inherit Metab Dis 24:437–447

    Article  PubMed  CAS  Google Scholar 

  8. Yap S, Boers GH, Wilcken B et al (2001) Vascular outcome in patients with homocystinuria due to cystathionine beta-synthase deficiency treated chronically: a multicenter observational study. Arterioscler Thromb Vasc Biol 21:2080–2085

    Article  PubMed  CAS  Google Scholar 

  9. Lim JS, Hwang JS, Cheon GJ, Lee JA, Kim DH, Park KD, Yi KH (2009) Gender differences in total and regional body composition changes as measured by dual-energy x-ray absorptiometry in Korean children and adolescents. J Clin Densitom 12:229–237

    Article  PubMed  Google Scholar 

  10. Lim JS, Hwang JS, Lee JA, Kim DH, Park KD, Cheon GJ, Shin CH, Yang SW (2010) Bone mineral density according to age, bone age, and pubertal stages in Korean children and adolescents. J Clin Densitom 13:68–76

    Article  PubMed  Google Scholar 

  11. Lubec B, Fang-Kircher S, Lubec T, Blom HJ, Boers GH (1996) Evidence for McKusick’s hypothesis of deficient collagen cross-linking in patients with homocystinuria. Biochim Biophys Acta 1315:159–162

    Article  PubMed  Google Scholar 

  12. Jackson SH (1973) The reaction of homocysteine with aldehyde: an explanation of the collagen defects in homocystinuria. Clin Chim Acta 45:215–217

    Article  PubMed  CAS  Google Scholar 

  13. van Meurs JB, Dhonukshe-Rutten RA, Pluijm SM, van der Klift M, de Jonge R, Lindemans J, de Groot LC, Hofman A, Witteman JC, van Leeuwen JP, Breteler MM, Lips P, Pols HA, Uitterlinden AG (2004) Homocysteine levels and the risk of osteoporotic fracture. N Engl J Med 350:2033–2041

    Article  PubMed  Google Scholar 

  14. Majors AK, Pyeritz RE (2000) A deficiency of cysteine impairs fibrillin-1 deposition: implications for the pathogenesis of cystathionine beta-synthase deficiency. Mol Genet Metab 70:252–260

    Article  PubMed  CAS  Google Scholar 

  15. Hill CH, Mecham R, Starcher B (2002) Fibrillin-2 defects impair elastic fiber assembly in a homocysteinemic chick model. J Nutr 132:2143–2150

    PubMed  CAS  Google Scholar 

  16. Massé PG, Boskey AL, Ziv I, Hauschka P, Donovan SM, Howell DS, Cole DE (2003) Chemical and biomechanical characterization of hyperhomocysteinemic bone disease in an animal model. BMC Musculoskelet Disord 20(4):2

    Article  Google Scholar 

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Acknowledgments

We thank all study participants for their valuable contributions to this study. We also thank Dr. Yong Jae Park for gathering and confirming data.

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Correspondence to D. H. Lee.

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Lim, J.S., Lee, D.H. Changes in bone mineral density and body composition of children with well-controlled homocystinuria caused by CBS deficiency. Osteoporos Int 24, 2535–2538 (2013). https://doi.org/10.1007/s00198-013-2351-4

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  • DOI: https://doi.org/10.1007/s00198-013-2351-4

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