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Osteoporosis in pediatric patients suffering from chronic inflammatory bowel disease with and without steroid treatment.
J Pediatr Gastroenterol Nutr. 2006 Jul; 43(1):42-51.JP

Abstract

BACKGROUND

Children and adolescents suffering from inflammatory bowel disease (IBD) are at risk of developing osteoporosis as a result of treatment with corticosteroids as well as of nonsteroidal factors like inflammation and malnutrition. To study the impact of these factors on development of osteopathy, we compared the rate of osteoporosis in steroid-naive and steroid-treated pediatric IBD patients.

METHODS

In 90 patients (50 girls) with IBD (34 steroid-naive, 53 steroid-treated, 3 not known) aged 8.8 to 19.2 (14.4 +/- 2.2) years and 52 controls (27 girls) aged 6.1 to 17.6 (12.9 +/- 3.0) years, bone mineral density (BMD) of the lumbar spine was assessed with dual energy x-ray absorptiometry. Areal BMD values were transformed into volumetric densities called bone mineral apparent density (BMAD) and expressed as standard deviation scores (SDS) on the basis of the BMAD values of the controls.

RESULTS

The rate of osteoporotic patients (BMAD-SDS < -2) was 8% in girls and 20% in boys. There was a similar proportion of osteoporosis in steroid-naive (12%) and steroid-treated (11%) patients. SDS of body height showed a significant positive correlation with BMD-SDS but not with BMAD-SDS in almost all patient subgroups, indicating an interfering dependency of BMD from bone size.

CONCLUSIONS

The prevalence of osteoporosis in pediatric patients with IBD is approximately the same as in adult patients. Osteoporosis is already present before steroid treatment. Data of dual energy x-ray absorptiometry measurements should be transformed into volumetric parameters to compensate for short stature. Otherwise, a lot of growth-stunted patients may be falsely diagnosed as osteopenic.

Authors+Show Affiliations

University Children's Hospital, Faculty of Medicine, University of Rostock, Rembrandtstrasse 16/17, D-18057 Rostock. frank.walther@med.uni-rostock.deNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16819376

Citation

Walther, Frank, et al. "Osteoporosis in Pediatric Patients Suffering From Chronic Inflammatory Bowel Disease With and Without Steroid Treatment." Journal of Pediatric Gastroenterology and Nutrition, vol. 43, no. 1, 2006, pp. 42-51.
Walther F, Fusch C, Radke M, et al. Osteoporosis in pediatric patients suffering from chronic inflammatory bowel disease with and without steroid treatment. J Pediatr Gastroenterol Nutr. 2006;43(1):42-51.
Walther, F., Fusch, C., Radke, M., Beckert, S., & Findeisen, A. (2006). Osteoporosis in pediatric patients suffering from chronic inflammatory bowel disease with and without steroid treatment. Journal of Pediatric Gastroenterology and Nutrition, 43(1), 42-51.
Walther F, et al. Osteoporosis in Pediatric Patients Suffering From Chronic Inflammatory Bowel Disease With and Without Steroid Treatment. J Pediatr Gastroenterol Nutr. 2006;43(1):42-51. PubMed PMID: 16819376.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Osteoporosis in pediatric patients suffering from chronic inflammatory bowel disease with and without steroid treatment. AU - Walther,Frank, AU - Fusch,Christoph, AU - Radke,Michael, AU - Beckert,Sybille, AU - Findeisen,Annette, PY - 2006/7/5/pubmed PY - 2007/3/14/medline PY - 2006/7/5/entrez SP - 42 EP - 51 JF - Journal of pediatric gastroenterology and nutrition JO - J Pediatr Gastroenterol Nutr VL - 43 IS - 1 N2 - BACKGROUND: Children and adolescents suffering from inflammatory bowel disease (IBD) are at risk of developing osteoporosis as a result of treatment with corticosteroids as well as of nonsteroidal factors like inflammation and malnutrition. To study the impact of these factors on development of osteopathy, we compared the rate of osteoporosis in steroid-naive and steroid-treated pediatric IBD patients. METHODS: In 90 patients (50 girls) with IBD (34 steroid-naive, 53 steroid-treated, 3 not known) aged 8.8 to 19.2 (14.4 +/- 2.2) years and 52 controls (27 girls) aged 6.1 to 17.6 (12.9 +/- 3.0) years, bone mineral density (BMD) of the lumbar spine was assessed with dual energy x-ray absorptiometry. Areal BMD values were transformed into volumetric densities called bone mineral apparent density (BMAD) and expressed as standard deviation scores (SDS) on the basis of the BMAD values of the controls. RESULTS: The rate of osteoporotic patients (BMAD-SDS < -2) was 8% in girls and 20% in boys. There was a similar proportion of osteoporosis in steroid-naive (12%) and steroid-treated (11%) patients. SDS of body height showed a significant positive correlation with BMD-SDS but not with BMAD-SDS in almost all patient subgroups, indicating an interfering dependency of BMD from bone size. CONCLUSIONS: The prevalence of osteoporosis in pediatric patients with IBD is approximately the same as in adult patients. Osteoporosis is already present before steroid treatment. Data of dual energy x-ray absorptiometry measurements should be transformed into volumetric parameters to compensate for short stature. Otherwise, a lot of growth-stunted patients may be falsely diagnosed as osteopenic. SN - 0277-2116 UR - https://www.unboundmedicine.com/medline/citation/16819376/Osteoporosis_in_pediatric_patients_suffering_from_chronic_inflammatory_bowel_disease_with_and_without_steroid_treatment_ L2 - https://doi.org/10.1097/01.mpg.0000228105.91240.80 DB - PRIME DP - Unbound Medicine ER -