Adiposity is associated with early reduction in bone mass in pediatric inflammatory bowel disease

Setty-Shah, Nithya; Maranda, Louise; Nwosu, Benjamin Udoka

doi:10.1016/j.nut.2016.01.004

Cited by 6 publications

(5 citation statements)

References 47 publications

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“…[7,18,19] In the current study, children with a lower BMI had more osteoporosis in total body and spinal BMD studies (P=0.038 and P=0.039, Saadah et al [13] found that low weight and height Z-scores were associated with the development of osteoporosis in patients with CD, yet low BMI Z-scores were not significantly associated with a low BMD. However, contrary to our findings, Setty-Shah et al [20] concluded that the AP spine BMD Z-score was much lower in obese IBD patients with high levels than in controls. Additionally, Wada et al [21] observed that IBD patients with a high BMI had low BMD levels.…”

Section: Discussioncontrasting

confidence: 99%

Bone Mineral Density in Patients with Pediatric Inflammatory Bowel Disease Using Dual Energy X-Ray Absorptiometry

et al. 2023

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Background: Inflammatory bowel disease (IBD) is a chronic inflammatory immune-mediated condition that affects the gastrointestinal system and alters bone growth and bone mineral density (BMD). Here we aimed to study the prevalence and predictors of a low BMD in pediatric patients with IBD.Methods: This retrospective cross-sectional analytical study included pediatric patients with IBD in whom BMD was evaluated using dual energy X-ray absorptiometry of the total body and lumbar spine. Osteoporosis was defined as a BMD Z-score ≤-2, osteopenia as -2 to -1, and normal as >-1. Clinical and laboratory findings were compared between patients with and without osteoporosis.Results: Of the 48 patients, 30 (62.5%) were males, 35 (72.9%) had Crohn’s disease, and 13 (27.1%) had ulcerative colitis. The mean age at diagnosis was 9.9±2.8 years. The median age at the time of the BMD scans was 11.9 (interquartile range, 9.9–14.3) years. Total body BMD scans identified 13 (27.1%) and 16 (33.3%) patients with osteoporosis and osteopenia, respectively. Spinal BMD scans revealed that 17 (39.5%) and 14 (32.6%) patients had osteoporosis and osteopenia, respectively. A low body mass index (BMI) Z-score (p=0.038), ileocolonic disease location (p=0.008), and a low calcium level (p=0.008) were significant predictors of osteoporosis on the total body BMD scans. A low BMI Z-score (p=0.039), decreased hemoglobin level (p=0.018), low calcium level (p=0.033), and infliximab use (p=0.019) were significant predictors of osteoporosis on the spinal BMD scans.Conclusions: This study showed a high prevalence of low BMD among pediatric patients with IBD. A low BMI, ileocolonic disease location, low hemoglobin and calcium levels, and infliximab use were significantly associated with osteoporosis.

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Section: Discussioncontrasting

confidence: 99%

Bone Mineral Density in Patients with Pediatric Inflammatory Bowel Disease Using Dual Energy X-Ray Absorptiometry

et al. 2023

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“…78 Furthermore, PCDAI was not found to be associated with BMD in 3 cross-sectional studies. 77,79,86 Statement 2.17. Sex, disease location, disease behavior, extraintestinal manifestations, granulomas, and perianal disease do not predict BMD (84% agreement).…”

Section: Supplementary Resultsmentioning

confidence: 99%

“…All 10 studies that examined nutritional status/anthropometrics in relation to reduced BMD reported an association with either lower weight or lower height. 29,[79][80][81][82][83][84][85][86][87] For weight, 9 of 9 studies were positive, 29,[79][80][81][82][83][84][85]87 and for height, 5 of 8 studies were positive, 79,80,83,85,88 whereas 3 were negative. 29,81,87 Importantly, most studies reporting on height were cross-sectional.…”

Section: Prognostic Factors For Surgerymentioning

confidence: 99%

Predicting Outcomes in Pediatric Crohn’s Disease for Management Optimization: Systematic Review and Consensus Statements From the Pediatric Inflammatory Bowel Disease–Ahead Program

et al. 2021

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BACKGROUND & AIMS:A better understanding of prognostic factors within the heterogeneous spectrum of pediatric Crohn's disease (CD) should improve patient management and reduce complications. We aimed to identify evidence-based predictors of outcomes with the goal of optimizing individual patient management. METHODS: A survey of 202 experts in pediatric CD identified and prioritized adverse outcomes to be avoided. A systematic review of the literature with meta-analysis, when possible, was performed to identify clinical studies that investigated predictors of these outcomes. Multiple national and international face-to-face meetings were held to draft consensus statements based on the published evidence. RESULTS: Consensus was reached on 27 statements regarding prognostic factors for surgery, complications, chronically active pediatric CD, and hospitalization. Prognostic factors for surgery included CD diagnosis during adolescence, growth impairment, NOD2/CARD15 polymorphisms, disease behavior, and positive anti-Saccharomyces cerevisiae antibody status. Isolated colonic disease was associated with fewer surgeries. Older age at presentation, small bowel disease, serology (anti-Saccharomyces cerevisiae antibody, antiflagellin, and OmpC), NOD2/ CARD15 polymorphisms, perianal disease, and ethnicity were risk factors for penetrating (B3) and/or stenotic disease (B2). Male sex, young age at onset, small bowel disease, more active disease, and diagnostic delay may be associated with growth impairment. Malnutrition and higher disease activity were associated with reduced bone density. CONCLUSIONS: These evidence-based consensus statements offer insight into predictors of poor outcomes in pediatric CD and are valuable when developing treatment algorithms and planning future studies. Targeted longitudinal studies are needed to further characterize prognostic factors in pediatric CD and to evaluate the impact of treatment algorithms tailored to individual patient risk.

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“…Rates of obesity are rising in patients with IBD, as in the general population; 15-40% of adults with IBD are obese, and 20-40% are overweight (18,19). Previous studies showed that the higher adiposity in early life in pediatrics with IBD and also in newly diagnosed IBD patients is signi cantly associated with reduced bone mass, as shown by BMD z-score (20,21).…”

Section: Discussionmentioning

confidence: 99%

The added value of trabecular bone score over bone mineral density for identification of the bone architecture in patients with Inflammatory Bowel Disease

Tavassoli¹,

Esmaeilii²,

Besharat³

et al. 2021

Preprint

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Background and aims:Patients with Inflammatory Bowel Disease (IBD) suffer from different level of bone diseases in density and architectures. This study has been designed to measure Bone Mineral Density (BMD) and Trabecular Bone Score (TBS) in IBD patients, Golestan province, northeast of Iran. Materials and methods:In this cross-sectional study during January 2018 to August 2018, 69 patients with IBD (UC=57 and Crohn’s disease=10; male: female 0.74; mean age, 39 years) recruited from the IBD registry in Golestan Research Center of Gastroentrology and Hepatology. After taking the informed consent, all patients have been interviewed by a trained physician and a questionnaire has been completed. Trabecular bone score (TBS) was performed using lumbar spine dual X-ray absorptiometry (DXA) images. After entering data into the SPSS-16 software, analysis was done using X2 and non-parametric tests.Results:Normal BMD (T Score>-1) was reported in 19 patients, low bone mass (-1 <T Score< -2.5) in 18 and osteoporosis (T Score <-2.5) in 4 patients. TBS results showed that 5 patients had partially degraded microarchitecture and 5 had fully degraded microarchitecture.Conclusion:In the present study on IBD patients, age, BMI, waist circumference and abdominal circumference had been correlated significantly with bone weakness. The duration of disease was correlated significantly with FRAX. The duration of disease was also correlated significantly with risk of major osteoporotic fracture in 10-years (FRAX adjusted MOF).

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Adiposity is associated with early reduction in bone mass in pediatric inflammatory bowel disease

Abstract: Adiposity was associated with reduced bone mass in the early phases of IBD, but with increased bone mass in the controls.

Cited by 6 publications

References 47 publications

Bone Mineral Density in Patients with Pediatric Inflammatory Bowel Disease Using Dual Energy X-Ray Absorptiometry

Bone Mineral Density in Patients with Pediatric Inflammatory Bowel Disease Using Dual Energy X-Ray Absorptiometry

Predicting Outcomes in Pediatric Crohn’s Disease for Management Optimization: Systematic Review and Consensus Statements From the Pediatric Inflammatory Bowel Disease–Ahead Program

The added value of trabecular bone score over bone mineral density for identification of the bone architecture in patients with Inflammatory Bowel Disease

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