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The prevalence of long bone fractures in pediatric inflammatory bowel disease
Rabindranath Persad1, Iqbal Jaffer, Robert M Issenman
1Division of Pediatric Gastroenterology and Nutrition, McMaster University and McMaster Children's Hospital Hamilton Health Sciences, Hamilton, Ontario, Canada.
Insights
This study found no significant difference in fracture rates between children with inflammatory bowel disease (IBD) and their healthy siblings. Our findings suggest IBD does not increase fracture risk in pediatric patients compared to controls.
Area of Science:
- Pediatric Gastroenterology
- Pediatric Orthopedics
- Bone Health
Background:
- Inflammatory bowel disease (IBD) is linked to reduced bone mineral density in adults, increasing fracture risk.
- Osteopenia affects up to 50% of adult IBD patients, highlighting a significant bone health concern.
- Understanding fracture prevalence in pediatric IBD is crucial for early intervention and management.
Purpose of the Study:
- To investigate the prevalence of fractures in children diagnosed with IBD.
- To compare fracture incidence in pediatric IBD patients against a control group of healthy siblings.
- To assess potential associations between IBD and fracture risk in a pediatric cohort.
Main Methods:
- A survey was distributed to families of 209 pediatric patients with IBD.
- Families compared fracture history of their IBD child with that of a healthy sibling.
- Data from 132 returned surveys (63% response rate) were analyzed, encompassing 263 children.
Main Results:
- Overall, 28% of children reported a history of fractures; 40% of these were IBD patients, and 60% were siblings.
- Among IBD patients, 59% reported fractures after diagnosis.
- The total number of fractures was 96 (41 in IBD patients, 55 in siblings).
Conclusions:
- This study found no statistically significant difference in fracture prevalence between pediatric IBD patients and their healthy siblings.
- The findings suggest that IBD may not confer an increased risk of fractures in children compared to their non-IBD peers.
- Further research may explore specific IBD subtypes or treatment effects on bone health in pediatric populations.
Introduction:
The association of inflammatory bowel disease (IBD) with decreased bone mineral density is well recognized. In the adult population, up to 50% of IBD patients are reported to have osteopenia, correlating with an increase in the incidence of fractures as compared with controls. The aim of this study was to determine the prevalence of fractures in a pediatric population with IBD as compared with healthy sibling controls (SC).
Patients And Methods:
The families of 209 patients with IBD were sent a questionnaire asking them to compare their children with IBD to a healthy sibling (non-IBD).
Results:
Surveys were returned by 132 of the 209 families (63%). The sample characteristics of this sample closely resembled the overall clinic population for age (mean 14.3 vs 14.7 years), gender (53% vs 59% male) and diagnosis (58.1 vs 57.8 Crohn disease). Completed surveys described 263 children. Of the 132 with IBD 73 (55%) had Crohn disease, 52 (39%) had ulcerative colitis and 7 (6%) had indeterminate colitis. There were 76/132 males (age range, 4-18 years) with IBD and 64/131 males (age range, 1-26 years) in the sibling controls. Mean ages of the IBD sample 14.3 +/-.3 was compared with 13.9 +/- in SC. Of the total group, 73/263 (28%) reported ever having a fracture, 44 (60%) were siblings (SC), and 29 (40%) had IBD. Of the 29 children with IBD, 17 (59%) reported having a fracture after diagnosis including 2 who had fractures both before and after diagnosis. The total number of fractures reported was 96 (55 SC:41 IBD).
Conclusion:
In this survey, we found no statistically significant difference in the prevalence of fracture in IBD patients compared with their normal siblings.
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