Bone Health in Children With Inflammatory Bowel Disease: Adjusting for Bone Age

Hill, Rebecca J.; Brookes, Denise S.K.; Lewindon, Peter; Withers, Geoffrey D.; Ee, Looi C.; Connor, Frances; Cleghorn, Geoffrey J.; Davies, Peter S. W.

doi:10.1097/mpg.0b013e31818cb4b6

Cited by 23 publications

(17 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…BA was lower than CA in our series of pediatric patients with CD, consistent with prior studies3,18. The importance of BA in interpreting growth in such patients was further demonstrated by observed sex differences in height BA-Z, but not CA-Z scores.…”

Section: Discussionsupporting

confidence: 91%

Sex differences in statural growth impairment in Crohnʼs disease: Role of IGF-1

Gupta

Lustig

Kohn

et al. 2011

Inflammatory Bowel Diseases

View full text Add to dashboard Cite

show abstract

Section: Discussionsupporting

confidence: 91%

Sex differences in statural growth impairment in Crohnʼs disease: Role of IGF-1

Gupta

Lustig

Kohn

et al. 2011

Inflammatory Bowel Diseases

View full text Add to dashboard Cite

show abstract

“…One-third of the patients had delayed BA, and BA-adjusted aBMD Z scores were significantly higher than CA-adjusted values, which emphasizes the importance of correcting the BMD values for delayed pubertal maturation when analyzing DXA results in both CD and UC patients. Most previous studies that have evaluated BA of pediatric IBD patients have reported significant delay of BA, with a mean difference of 0.5-1.2 years to CA [6,16,17,[32][33][34]. Two studies on IBD patients found no difference between BA and CA [3,5].…”

Section: Discussionmentioning

confidence: 91%

“…Gokhale et al [16] found that only girls with CD had significantly lower BMD than their healthy sibling controls when BMD Z scores were calculated for BA. Hill et al [17] reported significantly higher whole-body and lumbar spine BA-adjusted aBMD Z scores than CA-adjusted scores for 32 CD patients, whereas the CA and BA aBMD Z scores were not significantly different for 12 UC patients. In contrast to these studies, our study with more UC patients demonstrated higher BA aBMD Z scores in both CD and UC groups in comparison to CA aBMD Z scores.…”

Section: Discussionmentioning

confidence: 92%

See 1 more Smart Citation

Impaired Bone Health in Inflammatory Bowel Disease: A Case–Control Study in 80 Pediatric Patients

et al. 2012

View full text Add to dashboard Cite

Previous studies have indicated that children with inflammatory bowel disease (IBD) may not achieve optimal bone mass. We evaluated the skeletal characteristics in children and adolescents with IBD. This cross-sectional cohort study comprised 80 IBD patients (median age 14.9 years, range 5-20) with a median disease duration of 3.4 years; 51 had ulcerative colitis, 26 Crohn disease, and 3 unspecified colitis. Eighty age- and gender-matched healthy subjects served as controls. Areal bone mineral density (aBMD), body composition, and vertebral fractures (VFs) were assessed by DXA. Bone age (BA) was determined for IBD patients. Findings were correlated with disease- and treatment-related parameters and biochemistry. IBD patients had lower BA-adjusted lumbar spine and whole-body aBMD (p < 0.001 for both) and whole-body BMC adjusted for height (p = 0.02) than controls. Lean mass and fat mass Z scores did not differ between the groups, but IBD patients had lower whole-body BMC relative to muscle mass (p = 0.006). Despite vitamin D supplementation in 48 %, vitamin D deficiency was common. In IBD cumulative weight-adjusted prednisolone dose >150 mg/kg for the preceding 3 years increased the risk for low whole-body aBMD (OR = 5.5, 95 % CI 1.3-23.3, p = 0.02). VFs were found in 11 % of patients and in 3 % of controls (p = 0.02). IBD in childhood was associated with low aBMD and reduced bone mass accrual relative to muscle mass; the risk for subclinical VFs may be increased. These observations warrant careful follow-up and active preventive measures.

show abstract

“…Although these patients may not be considered “healthy” control subjects, we limited our selection to individuals with issues unlikely affecting vitamin D status. Although recent literature suggests that characterization of BMD should consider bone age, our data relies solely on chronologic age 39 . Because our study relied on separate cohorts for the comparisons of serum 25OHD concentration and bone density, our conclusions regarding vitamin D status and bone health should be interpreted with caution, and attempts to replicate this interesting finding in a single cohort would be warranted.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Status and Bone Mineral Density in African American Children With Crohn Disease

Middleton

Bhagavathula

Gaye

et al. 2013

J. pediatr. gastroenterol. nutr.

View full text Add to dashboard Cite

Background Vitamin D deficiency and low bone mineral density (BMD) are complications of inflammatory bowel disease. Vitamin D deficiency is more prevalent among individuals of color compared to Caucasians. There is little data comparing differences in serum 25-hydroxyvitamin D (25OHD) concentrations and BMD between African American and Caucasian children with Crohn’s Disease (CD). Methods We compared serum 25OHD concentrations of African American children with CD (n=52) to Caucasian children with CD (n=64) and healthy African American controls (n=40). We also analyzed BMD using dual energy x-ray absorptiometry (DXA) results from our pediatric CD population. Results African American children with CD had lower serum 25OHD concentrations [16.1 (14.5-17.9, 95%CI) ng/mL] than Caucasians with CD [22.3 (20.2-24.6, 95%CI) ng/mL; p<0.001]. African Americans with CD and controls exhibited similar serum 25OHD concentration [16.1 (14.5-17.9, 95%CI) vs 16.3 (14.4-18.4, 95%CI) ng/mL; NS]. African Americans with CD exhibited no difference in serum 25OHD concentration when controlling for seasonality, disease severity and surgical history, though serum 25OHD concentration was significantly decreased in overweight children (BMI≥85%, p =0.003). Multiple regression analysis demonstrated that obese African American females with CD had the lowest serum 25OHD concentrations [9.6 (6.8-13.5, 95%CI) ng/mL]. BMD was comparable between African American and Caucasian children with CD (Z score −0.4 ± 0.9 vs −0.7 ± 1.2; NS). Conclusions African American children with CD are more likely to have vitamin D deficiency compared to Caucasian with CD, but have similar BMD. CD disease severity and history of surgery do not affect serum 25OHD concentrations among African American children with CD. African American children have low serum 25OHD concentrations, independent of CD, compared to Caucasian children. Future should research should focus on how race affects vitamin D status and BMD in children with CD.

show abstract

Bone Health in Children With Inflammatory Bowel Disease: Adjusting for Bone Age

Cited by 23 publications

References 40 publications

Sex differences in statural growth impairment in Crohnʼs disease: Role of IGF-1

Sex differences in statural growth impairment in Crohnʼs disease: Role of IGF-1

Impaired Bone Health in Inflammatory Bowel Disease: A Case–Control Study in 80 Pediatric Patients

Vitamin D Status and Bone Mineral Density in African American Children With Crohn Disease

Contact Info

Product

Resources

About