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ABCD: Anthropometry, Body Composition, and Crohn Disease.
Denise S K Brookes1, Julie N Briody, Peter S W Davies
1*Faculty of Medicine and Biological Sciences, Children's Nutrition Research Centre, The University of Queensland†School of Medicine, The University of Queensland, Brisbane‡The Children's Hospital at Westmead, Sydney, Australia.
Journal of Pediatric Gastroenterology and Nutrition
|February 10, 2016
Summary
Young individuals with Crohn disease (CD) often have low bone mineral density (BMD) and lean tissue mass (LTM). Addressing LTM deficits is crucial for improving bone health in CD patients.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Metabolic Bone Disease
Background:
- Young individuals with Crohn disease (CD) face risks of diminished bone mineral density (BMD) and lean tissue mass (LTM).
- Lean tissue mass (LTM) plays a vital role in maintaining skeletal health for individuals with CD.
- Dual-energy x-ray absorptiometry (DXA) is utilized to assess BMD and LTM in CD patients.
Purpose of the Study:
- To evaluate bone mineral density (BMD) and lean tissue mass (LTM) in young individuals diagnosed with Crohn disease (CD).
- To identify deficits in BMD and LTM using a validated algorithm in a pediatric CD cohort.
- To understand the relationship between LTM, bone mineral content (BMC), and areal BMD in the context of CD.
Main Methods:
- A cohort of 57 pediatric patients with CD (ages 12.99-14.16 years) underwent anthropometric, disease activity, bone age, and DXA assessments.
- A four-step algorithm was employed to analyze DXA data, calculating z scores for areal BMD, height, LTM for height, and BMC for LTM.
- Low z scores were defined as values ≤1 standard deviation below population means.
Main Results:
- The CD cohort exhibited significantly low areal BMD z scores (P=0.00) and low LTM for height (P=0.00).
- Bone mineral content (BMC) appeared to compensate for reduced LTM, resulting in normalized areal BMD when adjusted for height and bone age.
- Correcting for bone age eliminated the low areal BMD z scores, while LTM for height and BMC for LTM z scores remained significantly low.
Conclusions:
- A clinical algorithm effectively identified significant LTM for height deficits in pediatric CD patients, irrespective of chronological or bone age.
- While BMC may adapt to reduced LTM, leading to seemingly normal areal BMD for age, persistent LTM deficits pose long-term risks to bone health.
- Prioritizing LTM improvement in clinical management is essential for mitigating chronic bone health consequences in individuals with Crohn disease.
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