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Growth, puberty, and bone health in children and adolescents with inflammatory bowel disease
Hye-Young Jin1, Jae-Sang Lim2, Yena Lee2
1Department of Pediatrics, Center for Pediatric Cancer, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea.
Insights
Endocrine complications like short stature and vitamin D deficiency are frequent in pediatric inflammatory bowel disease (IBD). Disease severity impacts growth, bone health, and pubertal development in children with IBD.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Bone Metabolism
Background:
- Pediatric inflammatory bowel disease (IBD) can lead to endocrine complications, including impaired growth, delayed puberty, and reduced bone mineral density (BMD).
- Understanding the frequency and characteristics of these complications is crucial for effective management.
Purpose of the Study:
- To investigate the frequency, characteristics, and outcomes of endocrine complications in children and adolescents with IBD.
- To assess the relationship between disease severity and endocrine dysfunction.
Main Methods:
- Retrospective review of 127 pediatric IBD patients (117 Crohn disease, 10 ulcerative colitis).
- Analysis of growth profiles, pubertal status, 25-hydroxyvitamin D levels, and BMD.
- Correlation of endocrine parameters with pediatric CD activity index scores.
Main Results:
- Short stature affected 11.0% of patients; height SDS did not significantly improve over 2 years.
- Delayed puberty occurred in 10.1% of eligible patients, linked to low weight SDS.
- Vitamin D deficiency was prevalent (81.7%), and 21.0% had osteoporosis.
- Higher disease activity correlated with decreased weight SDS, BMI SDS, IGF-1 SDS, and testosterone levels.
Conclusions:
- Vitamin D deficiency and osteoporosis are common in pediatric IBD.
- Worsening disease severity negatively impacts growth, bone health, and hormonal levels.
- Optimizing pubertal development is essential for maintaining bone health in pediatric IBD patients.
Background:
Endocrine complications such as impaired growth, delayed puberty, and low bone mineral density (BMD) can be associated with inflammatory bowel disease (IBD) in children and adolescents. This study was performed to investigate the frequency, characteristics, and outcomes of endocrine complications of IBD in children and adolescents.
Methods:
This study included 127 patients with IBD diagnosed before 18 years of age [117 with Crohn disease (CD) and 10 with ulcerative colitis (UC)]. Growth profiles, pubertal status, 25-hydroxyvitamin D3 [25(OH)D3] levels, and BMD were reviewed retrospectively.
Results:
Short stature was observed in 14 of 127 (11.0 %) with a mean height-SDS of -2.31 ± 0.72. During a 2-year follow-up period, height-SDS did not significantly improve, while weight-SDS significantly improved. Among 109 patients who were older than 13 (girls) or 14 (boys) years of age during the study period, 11 patients (10.1 %) showed delayed puberty, which was associated with low weight-SDS. Vitamin D deficiency was documented in 81.7 % (94/115) with the average 25(OH)D3 level of 14.5 ± 7.0 ng/mL. Lumbar BMD Z-score was below - 2 SDS in 25 of 119 patients (21.0 %). Height-SDS, weight-SDS, and body mass index (BMI)-SDS were lower in patients with osteoporosis than those without osteoporosis. When pediatric CD activity index scores were high (≥ 30), weight-SDS, BMI-SDS, insulin-like growth factor 1 (IGF-1)-SDS, and testosterone levels were significantly decreased.
Conclusions:
Vitamin D deficiency and osteoporosis are common in pediatric IBD patients. As disease severity deteriorates, weight-SDS, IGF-1-SDS, and testosterone levels were decreased. Optimal pubertal development is necessary for bone health.
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