Low bone mineral density in adults with complex congenital heart disease

Research output: Contribution to journalArticle


Aims: The majority of children with complex congenital heart disease (CHD) survive into adulthood due to advances in medical care. Adult patients with CHD have an increased incidence of diagnoses related to ageing such as heart failure, dementia, cancer and sarcopenia, despite a relatively low age. They also have a shorter life expectancy. It is unknown if their bone structures also show signs of premature ageing. We therefore investigated Bone Mineral Content (BMC) and bone mineral density (BMD) in an adult population with complex CHD. Methods: The total body BMC and BMD was examined using dual energy X-ray absorptiometry (DXA) in 73 adults with complex CHD (mean age 35.8 ± 14.3, women n = 22) and 73 age and sex matched controls. Results: The adults with complex CHD had lower total body BMC (2.6 ± 0.5 kg vs. 2.9 ± 0.5 kg, p < 0.001) and BMD (1.18 ± 0.12 g/cm2 vs. 1.26 ± 0.11 g/cm2, p < 0.001) compared to controls. BMD was lower for patients with single ventricle physiology and for the other complex diagnoses, and it persisted after correction for most common risk factors for osteoporosis. Conclusion: Adults with complex CHD have reduced total body BMC and BMD compared to healthy controls. These results are a sign of frailty that conforms with other previously reported signs of premature ageing. The risk of osteoporosis is low in our relatively young population, but it is assumed to increase with ageing. We recommend that clinicians pay close attention to risk factors for osteoporosis, and are generous in administering DXA-measurements in order to prevent future fractures among adults with complex CHD.


  • Camilla Sandberg
  • Karna Johansson
  • Christina Christersson
  • Joanna Hlebowicz
  • Ulf Thilén
  • Bengt Johansson
External organisations
  • Umeå University
  • Uppsala University
  • Kiruna Hospital
Research areas and keywords

Subject classification (UKÄ) – MANDATORY

  • Cardiac and Cardiovascular Systems
  • Public Health, Global Health, Social Medicine and Epidemiology


  • Bone density, Eisenmenger complex, Heart defect, congenital, Hypoplastic left heart syndrome, Tetralogy of Fallot, Transposition of great vessels
Original languageEnglish
Pages (from-to)62-66
Number of pages5
JournalInternational Journal of Cardiology
Early online date2020 Jul 3
Publication statusPublished - 2020 Nov 15
Publication categoryResearch