| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
|
|
|
|
|||||||||||||
|
|
|||||||||||||||
A M Boot
a Department of Paediatrics, Division
of Endocrinology, b Division of Gastroenterology, c Department of Nuclear Medicine, Erasmus University and
University Hospital Rotterdam/Sophia Children's Hospital, Rotterdam,
The Netherlands
Correspondence to: Dr A M Boot, Division of Endocrinology, Sophia Children's Hospital,
dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands. Accepted for publication 30 September 1997 Background Keywords:
bone mineral density;
inflammatory bowel disease;
children;
nutritional status;
corticosteroid treatment;
body
composition
Osteoporosis has been reported in
adult patients with inflammatory bowel disease.
AimsTo evaluate bone mineral density (BMD),
nutritional status, and determinants of BMD in children with
inflammatory bowel disease.
PatientsFifty five patients (34 boys and 21 girls, age range 4-18) were studied; 22 had Crohn's disease and 33 ulcerative colitis.
MethodsLumbar spine and total body BMD, and body
composition were assessed by dual energy x ray
absorptiometry (DXA). Results were expressed as standard deviation
scores (SDS). Lean body mass was also assessed by bioelectrical
impedance analysis (BIA). Yearly measurements during two years were
performed in 21 patients.
ResultsThe mean SDS of lumbar spine BMD and
total body BMD were significantly lower than normal (
0.75 and
0.95, both p<0.001). Height SDS and body mass index SDS were also
decreased. The decrease in BMD SDS could not be explained by delay in
bone maturation. The cumulative dose of prednisolone correlated
negatively with lumbar spine BMD SDS (r=0.32, p<0.02).
Body mass index SDS correlated positively with total body BMD SDS
(r=0.36, p<0.02). Patients with Crohn's disease had
significantly lower lumbar spine and total body BMD SDS than patients
with ulcerative colitis, even after adjustment for cumulative dose of
prednisolone. In the longitudinal data cumulative dose of prednisolone
between the measurements correlated negatively with the change in
lumbar spine and total body BMD SDS. Lean tissue mass measured by DXA
had a strong correlation with lean body mass measured by BIA
(r=0.98).
ConclusionsChildren with inflammatory bowel
disease have a decreased BMD. Children with Crohn's disease have a
higher risk of developing osteopaenia than children with ulcerative
colitis. Corticosteroid therapy and nutritional status are
important determinants of BMD in these patients.
(GUT 1998;42:188-194)
This article has been cited by other articles:
|
|
 |
|
  A. E. Wiskin, S. A. Wootton, and R. M. Beattie Nutrition Issues in Pediatric Crohn's Disease Nutr Clin Pract, April 1, 2007; 22(2): 214 - 222. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. M. Pappa, C. M. Gordon, T. M. Saslowsky, A. Zholudev, B. Horr, M.-C. Shih, and R. J. Grand Vitamin D Status in Children and Young Adults With Inflammatory Bowel Disease Pediatrics, November 1, 2006; 118(5): 1950 - 1961. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R M Beattie, N M Croft, J M Fell, N A Afzal, and R B Heuschkel Inflammatory bowel disease. Arch. Dis. Child., May 1, 2006; 91(5): 426 - 432. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. M Burnham, J. Shults, E. Semeao, B. J Foster, B. S Zemel, V. A Stallings, and M. B Leonard Body-composition alterations consistent with cachexia in children and young adults with Crohn disease Am. J. Clinical Nutrition, August 1, 2005; 82(2): 413 - 420. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M. Beattie Enteral Nutrition as Primary Therapy in Childhood Crohn's Disease: Control of Intestinal Inflammation and Anabolic Response JPEN J Parenter Enteral Nutr, July 1, 2005; 29(4_suppl): S151 - S159. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D J Chinn, J N Fordham, M S Kibirige, N J Crabtree, J Venables, J Bates, and O Pitcher Bone density at the os calcis: reference values, reproducibility, and effects of fracture history and physical activity Arch. Dis. Child., January 1, 2005; 90(1): 30 - 35. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. B. Leonard, H. I. Feldman, J. Shults, B. S. Zemel, B. J. Foster, and V. A. Stallings Long-Term, High-Dose Glucocorticoids and Bone Mineral Content in Childhood Glucocorticoid-Sensitive Nephrotic Syndrome N. Engl. J. Med., August 26, 2004; 351(9): 868 - 875. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A Sentongo, E. J Semaeo, N. Stettler, D. A Piccoli, V. A Stallings, and B. S Zemel Vitamin D status in children, adolescents, and young adults with Crohn disease Am. J. Clinical Nutrition, November 1, 2002; 76(5): 1077 - 1081. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T Mushtaq and S F Ahmed The impact of corticosteroids on growth and bone health Arch. Dis. Child., August 1, 2002; 87(2): 93 - 96. [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Soyka, W. P. Fairfield, and A. Klibanski Hormonal Determinants and Disorders of Peak Bone Mass in Children J. Clin. Endocrinol. Metab., November 1, 2000; 85(11): 3951 - 3963. [Full Text]
|
|
|
|
|
|
M. Thearle, M. Horlick, J. P. Bilezikian, J. Levy, J. M. Gertner, L. S. Levine, M. Harbison, W. Berdon, and S. E. Oberfield Osteoporosis: An Unusual Presentation of Childhood Crohn's Disease J. Clin. Endocrinol. Metab., June 1, 2000; 85(6): 2122 - 2126. [Abstract] [Full Text]
|
|
|
|
 |
|
 I. Bjarnason Metabolic bone disease in patients with inflammatory bowel disease Rheumatology, September 1, 1999; 38(9): 801 - 804. [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS | REGISTER |
