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Natural history of bone metabolism and bone mineral density in children with inflammatory bowel disease.
Inflamm Bowel Dis. 2007 Jan; 13(1):42-50.IB

Abstract

BACKGROUND

In children with inflammatory bowel disease (IBD) it is not known whether reductions in bone mineral density (BMD) are a consequence of bone turnover alterations and if BMD improves with treatment.

METHODS

In a cohort of children with IBD, we prospectively measured indicators of bone remodeling, body mass index (BMI), disease activity, intact parathyroid hormone, serum IL-6, and insulin-like growth factor-I at diagnosis and then every 6 months for 2 years. BMD was determined annually using dual x-ray absorptiometry (DXA). BMD Z-scores were calculated using height/age. Baseline measurements and calcium intake were compared with a group of age- and sex-matched healthy children.

RESULTS

We observed that at diagnosis total body BMD Z-score (mean +/- SD) was -0.78 +/- 1.02 for Crohn's disease (CD, n = 58), -0.46 +/- 1.14 for ulcerative colitis (UC, n = 18), and -0.17 +/- 0.95 for control (CL, n = 49) (P < 0.01, CD versus CL). In CD, a BMD Z-score <-1.0 was associated with lower BMI and higher serum IL-6. Patients with CD and UC had low bone turnover. Activation of bone formation paralleled clinical improvement, but BMC gain was less than expected over the 2-year study period, especially in CD. Prednisone use did not correlate with low BMD.

CONCLUSIONS

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.

Authors+Show Affiliations

Division of Gastroenterology and Nutrition, Connecticut Children's Medical Center, Hartford, Connecticut 06106, USA. fsylves@ccmckids.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17206638

Citation

Sylvester, Francisco A., et al. "Natural History of Bone Metabolism and Bone Mineral Density in Children With Inflammatory Bowel Disease." Inflammatory Bowel Diseases, vol. 13, no. 1, 2007, pp. 42-50.
Sylvester FA, Wyzga N, Hyams JS, et al. Natural history of bone metabolism and bone mineral density in children with inflammatory bowel disease. Inflamm Bowel Dis. 2007;13(1):42-50.
Sylvester, F. A., Wyzga, N., Hyams, J. S., Davis, P. M., Lerer, T., Vance, K., Hawker, G., & Griffiths, A. M. (2007). Natural history of bone metabolism and bone mineral density in children with inflammatory bowel disease. Inflammatory Bowel Diseases, 13(1), 42-50.
Sylvester FA, et al. Natural History of Bone Metabolism and Bone Mineral Density in Children With Inflammatory Bowel Disease. Inflamm Bowel Dis. 2007;13(1):42-50. PubMed PMID: 17206638.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Natural history of bone metabolism and bone mineral density in children with inflammatory bowel disease. AU - Sylvester,Francisco A, AU - Wyzga,Nancy, AU - Hyams,Jeffrey S, AU - Davis,Patricia M, AU - Lerer,Trudy, AU - Vance,Katherine, AU - Hawker,Gillian, AU - Griffiths,Anne M, PY - 2007/1/9/pubmed PY - 2007/3/23/medline PY - 2007/1/9/entrez SP - 42 EP - 50 JF - Inflammatory bowel diseases JO - Inflamm Bowel Dis VL - 13 IS - 1 N2 - BACKGROUND: In children with inflammatory bowel disease (IBD) it is not known whether reductions in bone mineral density (BMD) are a consequence of bone turnover alterations and if BMD improves with treatment. METHODS: In a cohort of children with IBD, we prospectively measured indicators of bone remodeling, body mass index (BMI), disease activity, intact parathyroid hormone, serum IL-6, and insulin-like growth factor-I at diagnosis and then every 6 months for 2 years. BMD was determined annually using dual x-ray absorptiometry (DXA). BMD Z-scores were calculated using height/age. Baseline measurements and calcium intake were compared with a group of age- and sex-matched healthy children. RESULTS: We observed that at diagnosis total body BMD Z-score (mean +/- SD) was -0.78 +/- 1.02 for Crohn's disease (CD, n = 58), -0.46 +/- 1.14 for ulcerative colitis (UC, n = 18), and -0.17 +/- 0.95 for control (CL, n = 49) (P < 0.01, CD versus CL). In CD, a BMD Z-score <-1.0 was associated with lower BMI and higher serum IL-6. Patients with CD and UC had low bone turnover. Activation of bone formation paralleled clinical improvement, but BMC gain was less than expected over the 2-year study period, especially in CD. Prednisone use did not correlate with low BMD. CONCLUSIONS: 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. SN - 1078-0998 UR - https://www.unboundmedicine.com/medline/citation/17206638/Natural_history_of_bone_metabolism_and_bone_mineral_density_in_children_with_inflammatory_bowel_disease_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&amp;PAGE=linkout&amp;SEARCH=17206638.ui DB - PRIME DP - Unbound Medicine ER -