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• W1990928863 abstract "Aim: Low bone mineral density (BMD) has been recognized as a potential problem in children with inflammatory bowel disease (IBD). Our aim was to investigate BMD in Swedish children and adolescents with IBD and to assess possible differences between the patient groups. Methods: In this population-based study, a total of 144 IBD patients (93 boys and 51 girls, mean age 14.2 years, range 6–19 years) from two pediatric centres in Western Sweden were enrolled: 83 with ulcerative colitis (UC), 45 with Crohn's disease (CD), and 16 with indeterminate colitis (IC). To evaluate BMD they underwent a dual-X-ray-absorptiometry (DXA) of the whole body, the spine and the hip. BMD values were expressed as Z-scores. Results: In our group of IBD patients, the lowest BMD values were found in the spine. BMD of the spine in the whole IBD group was significantly reduced compared to healthy references (mean Z-score -0.8 SD, range -5.9 SD – 3.7 SD, p<0.001). A significant reduction was found in CD (mean Z-score of the spine -1.1 SD, range -5.9 SD – 2.4 SD, p<0.01) as well as in UC patients (mean Z-score -0.8 SD, range -4.4 SD – 3.7 SD, p<0.001). Twenty one of 45 patients (46.7%) with CD had a mean Z-score of the spine lower than -1 SD compared to 39 of 83 with UC (47.0%). Twelve of 45 patients (26.7%) with CD had a mean Z-score of the spine lower than -2 SD compared to 20 of 83 with UC (24.1%). Additionally the mean Z-score of the spine in boys with IBD tended to be lower (-1 SD, range -5.9 SD – 2.4 SD) than in girls (-0.4 SD, range -3.7 SD – 3.7 SD, p=0.06). When performing a multiple regression analysis, risk for lower BMD in the spine was not related to diagnosis, treatment with steroids or disease duration. In contrast, there was a significant correlation to body-mass-index (BMI, p<0.001), treatment with Azathioprine (AZA, p<0.001) and male gender (p<0.05) found. Summary: In our pediatric group of patients with IBD, osteopenia with Z-score <-1 SD occurs in 46.7% of the individuals with CD and in 47% of those with UC. Severe osteopenia with Z-score less than -2 SD is present in 26.7% of the patients with CD and in 24.1% of the UC patients. Possible risk factors for lower BMD are male gender, low BMI and treatment with AZA. AZA is not known to have an effect itself on bone turnover. It is used in children with more active disease and we consider it therefore as a marker of disease course severity. Conclusions: Low bone mass is a prevalent clinical problem in Swedish pediatric patients with IBD. In a clinical setting, male gender, low BMI and treatment with AZA as a marker of disease course severity may be helpful to identify patients who should be screened by DXA." @default.
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• W1990928863 date "2006-11-01" @default.
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• W1990928863 title "Low Bone Mineral Density in Swedish Children and Adolescents with IBD: A Population-based Study" @default.
• W1990928863 doi "https://doi.org/10.1097/01.mpg.0000256264.60986.53" @default.
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