Young Adult Male Patients With Childhood-onset IBD Have Increased Risks of Compromised Cortical and Trabecular Bone
Gudmundur Vignir Sigurdsson1,2, Susanne Schmidt3, Dan Mellström4
1Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at the University of Gothenburg, and Queen Silvia's Children's Hospital, Gothenburg, Sweden.
Insights
Young adults with childhood-onset inflammatory bowel disease (IBD) exhibit poorer bone quality, including reduced cortical and trabecular structures. These findings highlight significant skeletal health risks in this patient group.
Area of Science:
- Bone biology and metabolism
- Inflammatory bowel disease (IBD) research
- Young adult health outcomes
Background:
- Childhood-onset inflammatory bowel disease (IBD) is linked to increased risks of low bone mineral density and muscle mass in young adults.
- Limited research exists on volumetric bone mineral density (vBMD), bone geometry, and microstructures in this population.
- The association between these bone parameters, skeletal muscle index (SMI), and physical exercise in young adult IBD patients requires further investigation.
Purpose of the Study:
- To investigate bone geometry, volumetric bone mineral density (vBMD), and bone microstructures in young adult males with childhood-onset IBD.
- To compare these bone parameters between IBD patients and age- and height-matched controls.
- To determine the independent associations of IBD diagnosis, skeletal muscle index (SMI), and physical exercise with bone health.
Main Methods:
- High-resolution peripheral quantitative computed tomography (HR-pQCT) scans were performed on 49 young adult male patients with childhood-onset IBD and 245 controls.
- Bone geometry, vBMD, and bone microstructures were calculated and compared between groups.
- Multivariable linear regression analyses were used to assess associations between IBD, SMI, and physical exercise.
Main Results:
- Young adult IBD patients showed significantly smaller cortical area, lower total and cortical vBMD compared to controls.
- IBD patients had lower trabecular volume fraction and thinner trabeculae.
- These differences in bone structure persisted after adjusting for SMI and physical exercise.
Conclusions:
- Young adult men with childhood-onset IBD have significantly reduced bone quality in both cortical and trabecular bone.
- These findings indicate an increased risk of compromised skeletal integrity in this group.
- Bone health in childhood-onset IBD requires careful monitoring and management.
Background:
Young adults with childhood-onset inflammatory bowel disease (IBD) have increased risks of low areal bone mineral density and low skeletal muscle mass. Volumetric BMD (vBMD), bone geometry and microstructures, in addition to possible associations with skeletal muscle index (SMI) and physical exercise have been scarcely studied in this patient group.
Patients And Methods:
In total, 49 young adult male patients with childhood-onset IBD and 245 age- and height-matched young adult male controls were scanned with high-resolution peripheral quantitative computed tomography. Bone geometry, vBMD, and bone microstructures were calculated as median values and compared between the patients and controls. Multivariable linear regression analyses were performed to determine the independent associations among IBD diagnosis, SMI (kg/m2), and physical exercise.
Results:
The group of young adult patients had, in comparison with the controls, significantly smaller median cortical area (126.1 mm2 vs151.1 mm2, P < .001), lower median total vBMD (296.7 mg/cm3 vs 336.7 mg/cm3, P < .001), and lower median cortical vBMD (854.4 mg/cm3 vs 878.5 mg/cm3, P < .001). Furthermore, the patients compared with the controls had lower median trabecular volume fraction (16.8% vs 18.2%, P < .001) and thinner median trabeculae (0.084 mm vs 0.089 mm, P < .001). The differences between the patients with IBD and controls persisted in multivariable analyses that included adjustments for SMI and physical exercise.
Conclusions:
Young adult men with childhood-onset IBD are at increased risk of having reduced bone quality in both the cortical and trabecular bone structures compared with normative matched controls.
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