Reduced bone mineral density (BMD) has been reported in children with established inflammatory bowel disease.
In this study, researchers from London, England, examined the bone mineral density, within 3 months of diagnosis, in children with IBD.
The children with IBD underwent dual-energy x ray absorptiometry (DEXA) of the whole body (BMD WB) and lumbar spine (BMD LS).
The research team matched data for age, sex, and race.
|Bone mineral density was reduced both in the whole body and the lumbar spine.|
Data were expressed as standard deviation scores (SDS).
Bone age was recorded (Tanner-Whitehouse) and the BMD adjusted accordingly.
The team also compared CD and UC/IC group data using the Mann-Whitney U test.
The researchers defined osteopenia is as BMD SDS between -1.0 and -2.5, and osteoporosis < -2.5.
The team studied 21 children (8 male, 13 female) with a median age of 12.8 years.
Of these, 14 had Crohn’s disease (CD), 6 ulcerative colitis (UC), and 1 indeterminate colitis (IC).
The team found that bone age was delayed (>) 2 years) in 1 child and advanced (> 2 years) in 2 children.
The median body mass index Z score was -1.08. This was significantly lower in CD patients compared to UC (-0.97 versus 1.0).
Height for age Z score was -0.06.
The researchers determined that BMD was reduced both in the whole body (median SDS – 1.08) and the lumbar spine (-1.38). In addition, they identified a trend to these scores being worse in the CD group.
BMD WB SDS was less than -1 in 52% of the 21 subjects. The team found osteopenia in 39% and osteoporosis in 13%.
Furthermore, BMD LS SDS was less than -1 in 66% (osteopenia in 42% and osteoporosis in 24%).
When the team used BMD not corrected for bone age for the whole body, 25% had a BMD score of less than -1 (osteopenia in 25% and osteoporosis in 0%). For the lumbar spine, 38% had a BMD score of less than -1 (osteopenia in 28% and osteoporosis in 10%).
The team found no significantly increased frequency in these abnormalities in the CD group over the UC group.
Dr Croft’s team concluded, “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 low BMD must be clarified for the pediatric population”.