Reduced muscle mass and bone size in pediatric patients with inflammatory bowel disease

Bechtold, Susanne; Alberer, Martin; Arenz, Tina; Putzker, Stephanie; Filipiak-Pittroff, Birgit; Schwarz, Hans; Koletzko, Sibylle

doi:10.1002/ibd.21021

Cited by 66 publications

(67 citation statements)

References 36 publications

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“…Bone and muscle parameters were measured by pQCT (XCT-2000 scanner; Stratec, Pforzheim, Germany) as described previously [20]. In brief, at the nondominant forearm, the scanner was positioned corresponding to 4 and 65% of forearm length, and at both sites 2-mm-thick single tomographic slices were measured with a voxel size of 0.4 mm.…”

Section: Methodsmentioning

confidence: 99%

“…Bone parameters were analyzed as described previously [20] at baseline, week 4, 12, and 24 and included insulin-like growth factor 1 (IGF-1), insulin-like growth factor-binding protein 3 (IGF-BP), C-terminal propeptide of type I collagen (C1CP), bone-specific alkaline phosphatase (bsaP), intact parathyroid hormone (iPTH), desoxypyridinoline (DPD, urine), and 25-OH vitamin D. A 25-OH vitamin D level <10 ng/ml was considered as insufficient, between 10 and 20 ng/ml as deficient, and >20 ng/ml as normal. In addition, vitamin K status was assessed by measuring plasma phylloquinone (vitamin K1) and PIVKA-II (prothrombin produced in vitamin K absence) [23].…”

Section: Methodsmentioning

confidence: 99%

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Influence of Exclusive Enteral Nutrition Therapy on Bone Density and Geometry in Newly Diagnosed Pediatric Crohn's Disease Patients

Werkstetter¹,

Schatz²,

Alberer³

et al. 2013

Ann Nutr Metab

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Background and Aims: Exclusive enteral nutrition (EEN) induces remission in patients with Crohn's disease (CD). We investigated the short-term impact of EEN on bone quality and muscle mass in children with CD. Methods: Ten newly diagnosed CD patients (7 male, 10.6-17.7 years of age) were assessed by peripheral quantitative computed tomography (pQCT) at the forearm before starting an 8-weeks treatment with EEN, and after 12 and 52 weeks. No steroids or biologicals were applied. Trabecular and cortical bone mineral density, total bone, and muscle cross-sectional area (CSA) were measured by pQCT and expressed as age- and sex-specific z-scores; size-dependent CSAs were corrected for low height for age. Wilcoxon rank sum test was applied. Results: Remission at week 12 was achieved in 8 patients; 2 still had mild disease. Initially low trabecular density z-scores improved (+0.3; p = 0.006) at week 12; simultaneously, the increased cortical density z-scores normalized (-0.4; p = 0.027). The low z-score for muscle CSA corrected for height (median -2.5, range -3.49 to -0.97) increased within 12 weeks (+1.0; p = 0.002) with no further improvement thereafter. Conclusions: The results indicate disturbed bone remodeling and severely impaired muscle mass in newly diagnosed CD children. Bone metabolism and muscle mass improved within 3 months after starting EEN with no further normalization thereafter.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Influence of Exclusive Enteral Nutrition Therapy on Bone Density and Geometry in Newly Diagnosed Pediatric Crohn's Disease Patients

Werkstetter¹,

Schatz²,

Alberer³

et al. 2013

Ann Nutr Metab

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“…While both Dubner et al 58 and Bechtold et al 57 found that cortical vBMD in children with CD was not lower than that of control subjects, Liu et al 59 have shown that cortical vBMD is not significantly associated with mechanical properties (failure load, failure moment, and stiffness) in the tibia, but that total bone CSA and cortical CSA are associated with mechanical properties (i.e., periosteal and endosteal circumferences). Therefore, in terms of fracture risk reduction, cortical geometry, not cortical vBMD per se, is an important factor.…”

Section: New Assessment Techniquesmentioning

confidence: 95%

“…53 There are two studies that have investigated bone parameters using pQCT in children with CD. 57,58 Both studies have shown that trabecular vBMD is reduced in patients with CD compared with controls. It was reported by Dubner et al 58 that their patients were, on average, on the 10th percentile for trabecular vBMD for age, sex, and race, and that this was consistent with decreased bone formation, as a result of circulating inflammatory cytokines, and potentially, increased bone resorption.…”

Section: New Assessment Techniquesmentioning

confidence: 97%

Bones in pediatric Crohnʼs disease

Hill

Brookes

Davies

2011

Inflammatory Bowel Diseases

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There is evidence to suggest that the inflammation associated with Crohn's disease (CD) impacts the bone health of patients, predisposing them to early onset osteoporosis and increasing their risk of fracture. Fractures have been documented in patients with CD, with a high proportion of these being found during young adulthood, which suggests that these patients are not simply fracturing as a result of the normal aging process but rather due to the presence of CD. In population terms, patients with CD have increased risk of fracture compared with the general population. Studies in children suggest that, irrespective of time on corticosteroid therapy, the underlying systemic inflammation associated with CD is an independent detrimental influence on the bone health of children with CD. This poses the question as to whether the onset of disease in childhood predisposes the individual to increased risk of future fractures later in life, as a result of decreased peak bone mass during the growing years. It is generally believed that dual energy x-ray absorptiometry-assessed areal bone mineral density is a good indicator of fracture risk; however, several studies have shown this may not be the case. New research, utilizing peripheral quantitative computed tomography, which provides a true volumetric assessment of bone, suggests altered bone geometry in patients with CD, which poses a structural threat by being more brittle and susceptible to damage accumulation.

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“…Кроме того, дети с ВЗК особенно подвержены нару-шениям состояния костной ткани в связи с повышен- [14][15][16]. Тяжелую остеопению регистрируют у 3-6% детей с ЯК и у 12-18% пациентов с БК [14,[17][18][19].…”

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

Gorelov¹,

Каннер²

2018

Med. sov.

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Reduced muscle mass and bone size in pediatric patients with inflammatory bowel disease

Cited by 66 publications

References 36 publications

Influence of Exclusive Enteral Nutrition Therapy on Bone Density and Geometry in Newly Diagnosed Pediatric Crohn's Disease Patients

Influence of Exclusive Enteral Nutrition Therapy on Bone Density and Geometry in Newly Diagnosed Pediatric Crohn's Disease Patients

Bones in pediatric Crohnʼs disease

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

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