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Musculoskeletal health in newly diagnosed children with Crohn's disease.
Osteoporos Int. 2017 Nov; 28(11):3169-3177.OI

Abstract

We evaluated the impact of Crohn's disease on muscle and bone strength, mass, density, and geometry in children with newly diagnosed CD and found profound muscle and bone deficits; nevertheless, the prevalence of vertebral fractures at this time point was low.

INTRODUCTION

Crohn's disease (CD) is an inflammatory condition of the gastrointestinal tract that can affect the musculoskeletal system. The objective of this study was to determine the prevalence of vertebral fractures and the impact of CD on muscle and bone mass, strength, density, and geometry in children with newly diagnosed CD.

METHODS

Seventy-three children (26 girls) aged 7.0 to 17.7 years were examined within 35 days following CD diagnosis by lateral spine radiograph for vertebral fractures and by jumping mechanography for muscle strength. Bone and muscle mass, density, and geometry were assessed by dual-energy x-ray absorptiometry and peripheral quantitative computed tomography (pQCT).

RESULTS

Disease activity was moderate to severe in 66 (90%) patients. Mean height (Z-score -0.3, standard deviation (SD) 1.1, p = 0.02), weight (Z-score -0.8, SD 1.3, p < 0.01), body mass index (Z-score -1.0, SD 1.3, p < 0.01), lumbar spine areal bone mineral density (BMD; Z-score -1.1, SD 1.0, p < 0.01), total body bone mineral content (Z-score -1.5, SD 1.0, p < 0.01), and total body lean mass (Z-score -2.5, SD 1.1, p < 0.01) were all low for age and gender. pQCT showed reduced trabecular volumetric BMD at the tibial metaphysis, expansion of the bone marrow cavity and thin cortices at the diaphysis, and low calf muscle cross-sectional area. Jumping mechanography demonstrated low muscle power. Only one patient had a vertebral fracture.

CONCLUSIONS

Children with newly diagnosed CD have profound muscle and bone deficits; nevertheless, the prevalence of vertebral fractures at this time point was low.

Authors+Show Affiliations

Pediatric Bone Health Clinical Research Program, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada. Lward@cheo.on.ca. Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. Lward@cheo.on.ca.Pediatric Bone Health Clinical Research Program, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada. School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada.Shriners Hospital for Children, Department of Pediatrics, McGill University, Montreal, QC, Canada.Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON, Canada. Children's Hospital of Eastern Ontario Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.Department of Health Sciences, Brock University, St. Catharines, ON, Canada.Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.Department of Medical Imaging, Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, ON, Canada.Department of Medical Imaging, Children's Hospital of Eastern Ontario and University of Ottawa, Ottawa, ON, Canada.Department of Radiology, University of British Columbia, Vancouver, BC, Canada.Pediatric Bone Health Clinical Research Program, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.Pediatric Bone Health Clinical Research Program, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.Pediatric Bone Health Clinical Research Program, Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.Department of Pediatrics, University of Ottawa, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, ON, K1H 8L1, Canada. Children's Hospital of Eastern Ontario Inflammatory Bowel Disease Centre, Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28791436

Citation

Ward, L M., et al. "Musculoskeletal Health in Newly Diagnosed Children With Crohn's Disease." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 28, no. 11, 2017, pp. 3169-3177.
Ward LM, Ma J, Rauch F, et al. Musculoskeletal health in newly diagnosed children with Crohn's disease. Osteoporos Int. 2017;28(11):3169-3177.
Ward, L. M., Ma, J., Rauch, F., Benchimol, E. I., Hay, J., Leonard, M. B., Matzinger, M. A., Shenouda, N., Lentle, B., Cosgrove, H., Scharke, M., Konji, V. N., & Mack, D. R. (2017). Musculoskeletal health in newly diagnosed children with Crohn's disease. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 28(11), 3169-3177. https://doi.org/10.1007/s00198-017-4159-0
Ward LM, et al. Musculoskeletal Health in Newly Diagnosed Children With Crohn's Disease. Osteoporos Int. 2017;28(11):3169-3177. PubMed PMID: 28791436.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Musculoskeletal health in newly diagnosed children with Crohn's disease. AU - Ward,L M, AU - Ma,J, AU - Rauch,F, AU - Benchimol,E I, AU - Hay,J, AU - Leonard,M B, AU - Matzinger,M A, AU - Shenouda,N, AU - Lentle,B, AU - Cosgrove,H, AU - Scharke,M, AU - Konji,V N, AU - Mack,D R, Y1 - 2017/08/08/ PY - 2017/02/22/received PY - 2017/07/11/accepted PY - 2017/8/10/pubmed PY - 2018/8/28/medline PY - 2017/8/10/entrez KW - Bone mineral density KW - Children KW - Crohn’s disease KW - Muscle function SP - 3169 EP - 3177 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 28 IS - 11 N2 - : We evaluated the impact of Crohn's disease on muscle and bone strength, mass, density, and geometry in children with newly diagnosed CD and found profound muscle and bone deficits; nevertheless, the prevalence of vertebral fractures at this time point was low. INTRODUCTION: Crohn's disease (CD) is an inflammatory condition of the gastrointestinal tract that can affect the musculoskeletal system. The objective of this study was to determine the prevalence of vertebral fractures and the impact of CD on muscle and bone mass, strength, density, and geometry in children with newly diagnosed CD. METHODS: Seventy-three children (26 girls) aged 7.0 to 17.7 years were examined within 35 days following CD diagnosis by lateral spine radiograph for vertebral fractures and by jumping mechanography for muscle strength. Bone and muscle mass, density, and geometry were assessed by dual-energy x-ray absorptiometry and peripheral quantitative computed tomography (pQCT). RESULTS: Disease activity was moderate to severe in 66 (90%) patients. Mean height (Z-score -0.3, standard deviation (SD) 1.1, p = 0.02), weight (Z-score -0.8, SD 1.3, p < 0.01), body mass index (Z-score -1.0, SD 1.3, p < 0.01), lumbar spine areal bone mineral density (BMD; Z-score -1.1, SD 1.0, p < 0.01), total body bone mineral content (Z-score -1.5, SD 1.0, p < 0.01), and total body lean mass (Z-score -2.5, SD 1.1, p < 0.01) were all low for age and gender. pQCT showed reduced trabecular volumetric BMD at the tibial metaphysis, expansion of the bone marrow cavity and thin cortices at the diaphysis, and low calf muscle cross-sectional area. Jumping mechanography demonstrated low muscle power. Only one patient had a vertebral fracture. CONCLUSIONS: Children with newly diagnosed CD have profound muscle and bone deficits; nevertheless, the prevalence of vertebral fractures at this time point was low. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/28791436/Musculoskeletal_health_in_newly_diagnosed_children_with_Crohn's_disease_ L2 - https://doi.org/10.1007/s00198-017-4159-0 DB - PRIME DP - Unbound Medicine ER -