Bone mineral density in children and young adults with Crohn's disease

Abstract

Reduced bone mineral density (BMD) has been reported in adults with Crohn's disease (CD). Less is known about abnormal BMD in children and young adults with CD. The aims of this study are to determine the prevalence of low BMD and to evaluate the effect of growth and pubertal development on BMD in children and young adults with CD. One hundred-nineteen patients with CD underwent dual-energy Xray absorptiometry (DXA) to determine BMD. Anthropometry and pubertal development were measured. Bone age was measured only in patients older than 8 years of age and who had not grown in height during the last year. One hundred-nineteen patients (72 male, 47 female) were evaluated. Seventy percent of patients had BMD z-scores 5 -1.0 and 32% had z-scores 5 -2.0. Weight and height z-scores were significantly associated with BMD z-scores. BMD z-scores based on bone age and on chronological age were highly correlated, except when the chronological age BMD z-score was 5 -2.0. BMD z-score was significantly different between males and females for the group (-1.75 k 1.06 vs. -1.08 k 1.00), respectively. Children and young adults with CD have a high prevalence of low BMD and routine evaluation by DXA is indicated. In patients with a chronological age-based BMD z-score 5 -2.0, a bone agebased BMD should be considered. Key Words: Bone mineral density-Bone mineral content-Crohn's disease-Dualenergy X-ray absorptiometry.

Effect of exclusive enteral nutrition on bone turnover in children with Crohn’s disease

“…Consequently, we are unable to determine whether the children in the present study had normal or reduced bone mass, or to define the impact of improved markers of bone turnover upon BMD. Previous reports have established reduced BMD in children at diagnosis of CD [34] and during their illness [12,30]. Normalization of bone turnover may lead to improved BMD over time, but likely only if ongoing inflammation is also controlled.…”

“…Reduced bone mineral density (BMD) has been reported in more than 40% of adult patients with inflammatory bowel disease (IBD) in cross-sectional studies [1][2][3] and is more prevalent in CD than in ulcerative colitis (UC) [1,[4][5][6][7][8]. These findings also extend to children with IBD, with several studies demonstrating reduced bone mass in comparison to healthy children [4,7,[9][10][11][12].…”

Vitamin D Status in Children and Young Adults With Inflammatory Bowel Disease

“…10 Children and adolescents with inflammatory bowel disease (IBD) have a higher prevalence of low BMD when compared with healthy peers. [11][12][13][14][15][16] Poor nutritional status, 15,16 delayed growth, 14,15 corticosteroid administration, 11,12,16 and the inflammatory process itself 12,17 have been reported as risk factors for this condition in children with IBD. The contribution of hypovitaminosis D to low BMD in children with IBD has not been systematically studied to date to our knowledge.…”

Maintenance therapy with infliximab for paediatric Crohn’s disease: impact on clinical remission and mucosal healing in Polish paediatric patients with severe Crohn’s disease

“…Inflammatory bowel disease (IBD) develops during childhood or adolescence in up to 25% of patients [2]. In children, both the disease and its treatment, which can include corticosteroids and immunomodulatory agents, can often result in significant long-term effects that include growth failure, osteopenia, and pathological fractures [3,4]. The "ideal" treatment of CD should therefore probably not only consist of the suppression of symptoms, but if at all possible also modification of the natural course of the disease.…”