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Pediatric-onset inflammatory bowel disease poses risk for low bone mineral density at early adulthood

Digestive and Liver Disease, June 2017, Volume 49, Issue 6, Pages 639-642

Abstract

BACKGROUND

Inflammatory bowel disease (IBD) is known to pose a risk for low bone mineral density (BMD) in children and adults. We aimed to evaluate the impact of pediatric-onset IBD on BMD in adulthood.

METHODS

Records of pediatric-IBD patients were retrospectively reviewed for documentation of dual-energy X-ray absorptiometry (DXA) scans in adulthood. BMD was expressed as z-score.

RESULTS

Sixty one patients were included. Mean (±SD) age at diagnosis was 14.7 (±2.4) years. Mean age at first DXA scan in adulthood was 23.9 years (±4.8). Median BMD z-score was −1.2 SD (IQR, −1.8 to −0.4), significantly lower than expected in normal population (p < 0.001). Osteopenia (BMD z-score ≤−1 SD) was noted in 44.3% (n = 27), and osteoporosis (BMD z-score ≤−2.5 SD) in 8.2% (n = 5). Bone-status showed no correlation with age, disease severity, vitamin D status at diagnosis, IBD subtype or duration of disease. Positive correlation (r = 0.306) was identified between low weight z-score at diagnosis and abnormal bone-status in adulthood. Among 36 patients with multiple DXA scans, there was no significant change in BMD during follow-up of 2.4 years.

CONCLUSIONS

Osteopenia and osteoporosis are frequent in adult IBD patients with pediatric-onset disease and correlates with low weight z-score at diagnosis.

KEYWORDS

Bone density, Crohn’s disease, Dual-energy X-ray absorptiometry, Ulcerative Colitis