ABSTRACT
I. Introduction As survival improves for persons with cystic fibrosis (CF), bone disease is increasingly recognized as a significant comorbidity. Manifestations of bone disease include low bone mineral density (BMD), bone pain, kyphosis, and fractures. The etiology is multifactorial, including overall malnutrition; deficiencies of vitamin D, vitamin K, and calcium; chronic infection and inflammation; steroid treatment; hypogonadism; low physical activity and reduced lean body mass (LBM); CF-related diabetes; and direct bone effects of cystic fibrosis transmembrane conductance regulator (CFTR) mutations. Prophylactic and therapeutic regimens should address each comorbidity if present, and may involve therapy with bisphosphonates in selected cases.
