Natural history of bone metabolism and bone mineral density in children with inflammatory bowel disease

Abstract

Decreased bone turnover occurs in children newly diagnosed with IBD. Although indicators of osteoblast activity increase with clinical improvement, bone mineral accrual does not accelerate. Children with low BMI may be considered for BMD screening, since they are at risk for low bone mass.

Bone turnover and metabolism in paediatric patients with inflammatory bowel disease treated with systemic glucocorticoids

“…This was not the case, as serum IGF-I levels did not correlate with the markers of bone formation or resorption either before, during, or after the glucocorticoid treatment. Before therapy the IGF-I levels were low in children with active IBD, consistent with previous studies (25,27). During the glucocorticoid therapy serum IGF-I levels showed an upward trend completely opposite to other markers related to bone turnover and declined only after the cessation of the steroid.…”

“…This is supported by the negative correlation between ESR/faecal calprotectin and serum PINP levels in our study and the fact that steroid-naive IBD patients may present with osteoporosis (23,24). Additionally, in active disease other factors such as nutrition or physical inactivity leading to reduced loading of the bones may also contribute to the low PINP levels (25). During the glucocorticoid therapy serum PINP levels decreased further, and after treatment were significantly higher than at baseline.…”

“…In children the study protocols have not specifically addressed the change of IGF-I levels during steroid therapy (25,27). As IGF-I levels parallel the markers of bone metabolism in adults, however, we hypothesized that this could be seen also in paediatric IBD patients (17).…”

Vitamin D and K status influences bone mineral density and bone accrual in children and adolescents with celiac disease

“…In CD, there are several potential explanations for the etiology of poor bone health. These include the potential for chronic malabsorption of nutrients known to influence bone formation (vitamins D, K and calcium), decreased dietary intake because of the presence of significant GI symptoms (diarrhea, anorexia) or the presence of chronic inflammation, which is known to influence bone metabolism by depressing bone synthesis and upregulating bone resorption (Sylvester et al, 2007). Other factors known to influence overall bone health include reductions in endogenous synthesis in vitamin D because of poor sunlight exposure, particularly in those living in northern climates and changes in weightbearing activity (Roth et al, 2005).…”

Inflammatory Bowel Diseases in Children: Peculiarities of the Disease Course and Therapy

“…Тяжелую остеопению регистрируют у 3-6% детей с ЯК и у 12-18% пациентов с БК [14,[17][18][19]. Улучшению синтеза костной ткани способствуют соот-ветствующая возрасту нутритивная поддержка, упраж-нения с весовыми нагрузками, а также адекватный контроль заболевания с преодолением гормональной зависимости [14,16,18,20]. В детском возрасте ВЗК имеют ряд особенностей: 1) чаще регистрируются более распространенные формы БК и ЯК; 2) менее специфичная, стертая клиническая картина болезней; 3) влияние болезни на физическое половое развитие ребенка.…”