Croft, N.M.; Ho, J.; Akanle, O.A.; Savage, M.O.; Sanderson, I.R.
April 2003
Gut;Apr2003 Supplement 1, Vol. 52, pA21
Academic Journal
Introduction: Significantly reduced bone mineral density (BMD) has been reported in cross sectional studies of children with established inflammatory bowel disease (IBD). In this study we have examined the bone mineral density within 3 months of diagnosis in children with IBD. Methods: Children with IBD underwent dual-energy x ray absorptiometry (DEXA) of the whole body (BMD WB) and lumbar spine (BMD LS) within 3 months from diagnosis. The data were matched for age, sex, and race and expressed as standard deviation scores (SDS). Bone age was recorded (Tanner-Whitehouse) and the BMD adjusted accordingly. CD and UC/IC group data were compared using the Mann-Whitney U test. Osteopenia is defined as BMD SDS between -1.0 and -2.5, osteoporosis < 2.5. Results: 21 children (8 male and 13 female), median age 12.8 years, have been studied. 14 had Crohn's disease (CD), 6 ulcerative colitis (UC), and 1 indeterminate colitis (lC). Bone age was delayed (> 2 years) in 1 and advanced (> 2 years) in 2 children. Median body mass index Z score was -1.08, significantly lower in CD v UC (-0.97 v 1.0). Height for age Z score was -0.06. BMD was reduced both in the whole body (median SDS -1.08) and lumbar spine (-1.38). There was a trend to these being worse in the CD group (BMD WB: CD -1.35 v UC/IC -0.46, p = 0.2; BMD LS, -1.95 v -1.0, p = 0.5). BMD WB SDS was < -1 in 52% of the 21 subjects (osteopenia in 39% and osteoporosis in 13%), and for BMD LS was 66% (osteopenia 42%, osteoporosis 24%). Using BMD not corrected for bone age for the whole body 25% had a BMD score < -1 (osteopenia 25%, osteoporosis 0%) and lumbar spine 38% (osteopenia 28% and osteoporosis in 10%). There was no significantly increased frequency in these abnormalities in the CD group over the UC group. Conclusions: These data demonstrate reduced bone mineral density at diagnosis in a high proportion of children with IBD. As peak BMD is not reached until early adulthood evidence based strategies to manage Iow BMD...


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