Introduction: Previous studies have reported an association between classic galactosemia (CG) and decreased bone mass. The primary objective of this systematic review with meta-analysis was to determine the extent of bone mineral density (BMD) Z-score reduction. Low BMD was defined as a Z-score À2 standard deviations (SD). The secondary objective was to evaluate other indicators of bone status through a descriptive analysis.Methods: Systematic search strategies were developed by an experienced clinical librarian. Selection of relevant manuscripts, risk of bias assessment, and data extraction were performed independently by two investigators.Results: Four studies were included in the meta-analysis. BMD Z-scores in children and adults with CG measured at the lumbar spine (LBMD; 4 studies; n ¼ 112), total hip (HBMD; 2 studies; n ¼ 58), and femoral neck (FBMD; 2 studies; n ¼ 73) were assessed. Mean BMD Z-scores in the CG population were LBMD À0.70 (95% CI: À0.88, À0.52); HBMD À0.89 (95% CI: À1.14, À0.64); and FBMD À0.63 (95% CI À1.29, 0.02). Results from studies included in the descriptive analysis (n ¼ 7) show that vitamin D levels were frequently in the low reference range, whereas serum calcium levels were within reference range.Communicated by: Alberto B. Burlina, MDThe authors "Britt van Erven" and "Lindsey Welling" are equal first authors.The authors "M. Estela Rubio-Gozalbo" and "Annet M. Bosch" are equal first authors.
Electronic supplementary material:The online version of this chapter