Pediatric-onset inflammatory bowel disease poses risk for low bone mineral density at early adulthood.
BACKGROUND
Inflammatory bowel disease (IBD) is known to pose a risk for low bone mineral density (BMD) in children and adults. We aimed to evaluate the impact of pediatric-onset IBD on BMD in adulthood.


METHODS
Records of pediatric-IBD patients were retrospectively reviewed for documentation of dual-energy X-ray absorptiometry (DXA) scans in adulthood. BMD was expressed as z-score.


RESULTS
Sixty one patients were included. Mean (±SD) age at diagnosis was 14.7 (±2.4) years. Mean age at first DXA scan in adulthood was 23.9 years (±4.8). Median BMD z-score was -1.2 SD (IQR, -1.8 to -0.4), significantly lower than expected in normal population (p<0.001). Osteopenia (BMD z-score ≤-1 SD) was noted in 44.3% (n=27), and osteoporosis (BMD z-score ≤-2.5 SD) in 8.2% (n=5). Bone-status showed no correlation with age, disease severity, vitamin D status at diagnosis, IBD subtype or duration of disease. Positive correlation (r=0.306) was identified between low weight z-score at diagnosis and abnormal bone-status in adulthood. Among 36 patients with multiple DXA scans, there was no significant change in BMD during follow-up of 2.4 years.


CONCLUSIONS
Osteopenia and osteoporosis are frequent in adult IBD patients with pediatric-onset disease and correlates with low weight z-score at diagnosis.
Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Medical Center, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. Electronic address: anatguz@gmail.com.
Anat
A
Guz-Mark
Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Medical Center, Petah-Tikva, Israel.
Firas
F
Rinawi
Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center, Beilinson Campus, Petach-Tikva, Israel.
Oxana
O
Egotubov
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center, Beilinson Campus, Petach-Tikva, Israel.
Ilan
I
Shimon
Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Medical Center, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Raanan
R
Shamir
Institute of Gastroenterology, Nutrition and Liver Disease, Schneider Children's Medical Center, Petah-Tikva, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Amit
A
Assa
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D015519:Bone Density; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D007557:Israel; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014807:Vitamin D / Q000097:blood; D055815:Young Adult
D014807:Vitamin D
Bone density; Crohn’s disease; Dual-energy X-ray absorptiometry; Ulcerative Colitis