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Bone turnover and metabolism in paediatric patients with inflammatory bowel disease treated with systemic

Marianne K Vihinen1, Kaija-Leena Kolho, Merja Ashorn

  • 1Hospital for Children and Adolescents, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland. marianne.vihinen@helsinki.fi

European Journal of Endocrinology
|September 13, 2008
PubMed

Insights

Children with active inflammatory bowel disease (IBD) have compromised bone formation. Glucocorticoid treatment further suppresses bone turnover, but markers improve rapidly after steroid withdrawal.

Area of Science:

  • Pediatric Endocrinology
  • Gastroenterology
  • Bone Metabolism

Background:

  • Children with inflammatory bowel disease (IBD) often experience impaired bone health.
  • Systemic glucocorticoids are commonly used to manage IBD flares but can negatively impact bone turnover.

Purpose of the Study:

  • To investigate circulating markers of bone turnover in pediatric IBD patients before, during, and after systemic glucocorticoid therapy.
  • To assess the effects of glucocorticoids on bone formation and resorption in children with IBD.

Main Methods:

  • Studied 22 children with IBD requiring oral steroid therapy, measuring bone formation (PINP) and resorption (ICTP) markers, IGF-I, and SHBG.
  • Analyzed bone markers at baseline, 2 and 5 weeks during glucocorticoid treatment, and 1 month post-withdrawal.
  • Compared with 22 IBD patients in remission as controls.

Main Results:

  • Children with active IBD had lower baseline PINP and IGF-I compared to controls.
  • Glucocorticoid treatment significantly decreased PINP, ICTP, and SHBG levels within 2 weeks.
  • Serum IGF-I levels increased during glucocorticoid treatment.
  • All measured bone markers returned to control levels one month after steroid cessation.

Conclusions:

  • Bone formation is compromised in active pediatric IBD.
  • Systemic glucocorticoid therapy further suppresses bone turnover in these patients.
  • Bone markers demonstrate rapid improvement following glucocorticoid withdrawal.
Abstract

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