Authors: Sylvester Francisco A Wyzga Nancy Hyams Jeffrey S Davis Patricia M Lerer Trudy Vance Katherine Hawker Gillian Griffiths Anne M
Publish Date: 2007/01/01
Volume: 13, Issue: 1, Pages: 42-50
Abstract
Francisco A Sylvester Nancy Wyzga Jeffrey S Hyams Patricia M Davis Trudy Lerer Katherine Vance Gillian Hawker Anne M Griffiths Natural history of bone metabolism and bone mineral density in children with inflammatory bowel disease Inflammatory Bowel Diseases Volume 13 Issue 1 1 January 2007 Pages 42–50 https//doiorg/101002/ibd20006In a cohort of children with IBD we prospectively measured indicators of bone remodeling body mass index BMI disease activity intact parathyroid hormone serum IL6 and insulinlike growth factorI at diagnosis and then every 6 months for 2 years BMD was determined annually using dual xray absorptiometry DXA BMD Zscores were calculated using height/age Baseline measurements and calcium intake were compared with a group of age and sexmatched healthy childrenWe observed that at diagnosis total body BMD Zscore mean ± SD was −078 ± 102 for Crohns disease CD n = 58 −046 ± 114 for ulcerative colitis UC n = 18 and −017 ± 095 for control CL n = 49 P 001 CD versus CL In CD a BMD Zscore −10 was associated with lower BMI and higher serum IL6 Patients with CD and UC had low bone turnover Activation of bone formation paralleled clinical improvement but BMC gain was less than expected over the 2year study period especially in CD Prednisone use did not correlate with low BMDDecreased bone turnover occurs in children newly diagnosed with IBD Although indicators of osteoblast activity increase with clinical improvement bone mineral accrual does not accelerate Children with low BMI may be considered for BMD screening since they are at risk for low bone mass
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