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Bone Mass Development from Childhood into Young Adulthood in Patients with Childhood-onset Inflammatory Bowel Disease
Gudmundur Vignir Sigurdsson1, Susanne Schmidt, Dan Mellström
1*Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg and Queen Silvia Children's Hospital, Gothenburg, Sweden; †Premier Research LLC, Durham, North Carolina; ‡Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; and §Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg and Geriatric Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Insights
Children with inflammatory bowel disease (IBD) face a higher risk of low bone mineral density (BMD). This study tracked childhood-onset IBD patients into adulthood, finding males at risk for compromised BMD, while both sexes showed bone density improvements past typical peak ages.
Area of Science:
- Pediatric gastroenterology
- Bone metabolism
- Chronic disease management
Background:
- Children with inflammatory bowel disease (IBD) exhibit an elevated risk of low bone mineral density (BMD).
- Limited data exists on BMD development through puberty into young adulthood for pediatric IBD patients.
Purpose of the Study:
- To prospectively evaluate bone mineral density (BMD) development in patients with childhood-onset inflammatory bowel disease (IBD) into young adulthood.
- To identify potential sex-based differences in BMD trajectories and compare BMD between Crohn's disease and ulcerative colitis patients.
Main Methods:
- A prospective longitudinal study followed 74 children with IBD into young adulthood (mean 8.4 years follow-up).
- Bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry (DXA) of the lumbar spine, total hip, and whole body.
- BMD measurements were correlated with anthropometric data.
Main Results:
- Young adult males with IBD showed lower mean BMD Z-scores at the lumbar spine (-0.8 SD) and total hip (-0.5 SD) compared to references.
- Young adult females with IBD had BMD Z-scores within the normal range across all measured sites.
- Both male and female patients demonstrated significant improvements in lumbar spine BMD Z-scores during follow-up, extending beyond typical peak bone mass acquisition ages.
Conclusions:
- Male patients with childhood-onset IBD are at increased risk for compromised bone mineral density (BMD) in young adulthood.
- Both male and female IBD patients demonstrate continued bone accumulation in the lumbar spine beyond the expected age for peak bone mass.
- Findings suggest ongoing monitoring and potential interventions for BMD in pediatric IBD patients, particularly males.
Background:
Children who have inflammatory bowel disease (IBD) have increased risk of low bone mineral density (BMD). There is a scarcity of information on BMD development through puberty and into young adulthood in patients with childhood-onset IBD.
Methods:
We conducted a prospective longitudinal study of BMD in patients with childhood-onset IBD. In total, 74 children with IBD were followed into young adulthood, with a mean follow-up of 8.4 years. The BMD was assessed longitudinally using dual-energy X-ray absorptiometry of the lumbar spine, total hip and whole body, and related to anthropometric measures.
Results:
Young adult male patients with IBD had lower mean BMD Z-scores for the lumbar spine at -0.8 (±1.1 SD) and total hip at -0.5 (±0.9 SD), as compared to standard references. In young female patients, the BMD Z-scores were within the normal range at all 3 measured sites as compared to the standard references. There were no significant differences in the BMD Z-scores between patients with Crohn's disease and patients with ulcerative colitis. The female and male patients showed significantly improved mean lumbar spine BMD Z-scores during follow-up into young adulthood, indicating that bone accumulation in the lumbar spine continues beyond the expected age for achieving peak bone mass.
Conclusions:
Male patients with childhood-onset IBD seem to have an increased risk of compromised BMD in young adulthood. Both female and male patients with IBD seem to increase their BMD beyond the age for expected peak bone mass (see Video abstract, Supplemental Digital Content 1, http://links.lww.com/IBD/B648).
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