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Adiposity is associated with early reduction in bone mass in pediatric inflammatory bowel disease
Nithya Setty-Shah1, Louise Maranda2, Benjamin Udoka Nwosu1
1Department of Pediatrics, University of Massachusetts Medical School, Worcester, Massachusetts, USA.
Insights
In pediatric inflammatory bowel disease (IBD), increased adiposity is linked to lower bone mass, unlike in healthy children. This study highlights a critical factor affecting bone health in early IBD stages.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Bone Metabolism
Background:
- The relationship between adiposity and bone mass in pediatric inflammatory bowel disease (IBD) during the early stages of the condition remains unclear.
- Understanding this relationship is crucial for managing bone health in children and adolescents with IBD.
Purpose of the Study:
- To investigate the effect of adiposity on bone mass within the first three years of diagnosis in pediatric IBD patients.
- To compare bone mineral density (BMD) in IBD subjects with that of healthy controls, considering body mass index (BMI).
Main Methods:
- A comparative study involving 25 pediatric IBD patients (diagnosed <4 years) and 24 age-matched controls.
- Height-adjusted bone mineral density (BMD) z-scores were measured. Overweight and obesity were defined by BMI percentiles.
- IBD disease activity was assessed using standardized indices.
Main Results:
- Overall, BMD z-scores were not significantly different between IBD subjects and controls before BMI stratification.
- However, overweight/obese IBD subjects showed significantly lower femoral neck BMD z-scores compared to overweight/obese controls (P=0.032).
- No significant relationship was found between BMD z-scores and disease duration, steroid use, or disease severity.
Conclusions:
- Adiposity is associated with reduced bone mass in pediatric IBD patients during the early disease phases.
- In contrast, adiposity was linked to increased bone mass in the control group.
- These findings suggest a complex interplay between adiposity, IBD, and bone health in pediatric populations.
Objectives:
The effect of adiposity on bone mass in the early phases of inflammatory bowel disease (IBD) in children and adolescents is unclear. The aim of this study was to determine the role of adiposity on bone mass in the first 3 y of diagnosis of IBD. The expected result is that increased adiposity will be associated with increased bone mass in both the controls and IBD subjects.
Methods:
Height-adjusted bone mineral density (BMD) z-scores of 25 subjects, age 13.97 ± 2.70 y, diagnosed with IBD for <4 y were compared to 24 controls, age 13.65 ± 2.60 y. Overweight was defined as BMI of ≥85th but <95th percentile, and obesity as BMI ≥95th percentile. Severity of IBD was determined by the Pediatric Crohn's Disease Activity Index and Lichtiger Colitis Activity Index.
Results:
Before stratification by BMI criterion, height-adjusted BMD z-scores were not significantly lower in IBD subjects versus controls for both the femoral neck (-0.8 ± 1.1 versus -0.06 ± 1.1, P = 0.070) and lumbar vertebrae (-0.4 ± 1.2 versus 0.2 ± 1.2, P = 0.086). Following stratification, height-adjusted BMD z-scores were significantly lower in the overweight/obese IBD subjects versus overweight/obese controls for femoral neck (-0.9 ± 0.9 versus 0.3 ± 1.3, P = 0.032); and non-significantly lower for the lumbar spine z-score (-0.4 ± 1.6 versus 0.5 ± 1.3, P = 0.197). BMD z-score had no relationship with the duration of disease, steroid therapy, and the severity of disease.
Conclusion:
Adiposity was associated with reduced bone mass in the early phases of IBD, but with increased bone mass in the controls.
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