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Bone Health in Pediatric Patients with IBD: What Is New?
Rebecca J Gordon1, Catherine M Gordon2,3
1Division of Endocrinology, Boston Children's Hospital, Harvard Medical School, 300 Longwood Avenue, Boston, MA, 02115, USA. Rebecca.Gordon@childrens.harvard.edu.
Insights
Inflammatory bowel disease (IBD) in children impairs bone formation, impacting peak bone mass. Treatment of IBD can improve bone health, but further research is needed to understand IBD’s complex effects on pediatric bone accrual.
Area of Science:
- Pediatric bone health
- Inflammatory Bowel Disease (IBD) research
- Immunometabolism
Background:
- Patients with inflammatory bowel disease (IBD) exhibit increased bone fragility, evidenced by higher fracture risk, reduced bone density, and altered bone geometry.
- The precise pathophysiology underlying these bone abnormalities in IBD patients remains incompletely understood.
- Growing evidence suggests intricate interactions between the immune system and bone metabolism.
Purpose of the Study:
- To review the pathophysiology of bone fragility in pediatric patients with inflammatory bowel disease (IBD).
- To highlight the impact of IBD on bone accrual in children and adolescents.
- To identify risk factors affecting bone health in pediatric IBD.
Main Methods:
- Literature review of studies on pediatric IBD and bone health.
- Analysis of evidence regarding immune system's role in bone metabolism.
- Examination of multi-factorial etiologies contributing to suboptimal bone accrual.
Main Results:
- Children and adolescents with IBD show decreased bone formation at diagnosis, which often improves with IBD treatment.
- Multi-factorial etiologies, including immune system interactions, contribute to poor bone accrual in pediatric IBD.
- Differential effects on bone health are observed based on IBD sub-type and specific bone compartments.
Conclusions:
- Pediatric patients with IBD face several risk factors that can negatively impact bone accrual and peak bone mass attainment.
- Understanding the complex interplay between IBD, the immune system, and bone metabolism is crucial.
- Further research is necessary to fully elucidate the effects of IBD on pediatric bone health.
Purpose Of The Review:
Patients with inflammatory bowel disease (IBD) have increased bone fragility, demonstrated by increased fracture risk, and often have low bone density and altered bone geometry, but the underlying pathophysiology remains poorly understood.
Recent Findings:
Children and adolescents with IBD appear to have decreased bone formation, at diagnosis, which frequently improves with treatment of their underlying IBD. There is a growing body of evidence regarding how the immune system interacts with bone metabolism. There are likely multi-factorial etiologies that contribute to suboptimal bone accrual and subsequent lack of peak bone mass attainment in growing patients with IBD. There appears to be differential effects dependent upon IBD sub-type and bone compartment. Pediatric patients with IBD require recognition of several risk factors that may adversely impact their bone accrual. Future studies are necessary to further delineate the effects of IBD on pediatric bone health.
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