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Longitudinal Assessment of Bone Mineral Density in a Population of Children and Adolescents with Inflammatory Bowel Disease.

Artikel i vetenskaplig tidskrift
Författare Susanne Schmidt
Dan Mellström
Ensio Norjavaara
Valter Sundh
Robert Saalman
Publicerad i Journal of pediatric gastroenterology and nutrition
Volym 55
Nummer/häfte 5
Sidor 511–518
ISSN 1536-4801
Publiceringsår 2012
Publicerad vid Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
Centre for Bone and Arthritis Research
Institutionen för kliniska vetenskaper, Avdelningen för pediatrik
Institutionen för medicin, avdelningen för invärtesmedicin
Sidor 511–518
Språk en
Länkar dx.doi.org/10.1097/MPG.0b013e318258...
Ämnesord bone mineral density (BMD), children, inflammatory bowel disease (IBD), vitamin D, parathyroid hormone (PTH)
Ämneskategorier Pediatrik

Sammanfattning

OBJECTIVES:: Low bone mineral density (BMD) is recognized as a potential problem in children with inflammatory bowel disease (IBD). We aimed to describe the longitudinal development of BMD in a population of Swedish pediatric patients with IBD. METHODS:: A total of 144 IBD patients (93 males; 83 with ulcerative colitis (UC), 45 with Crohn's disease (CD)) were examined with dual-energy X-ray absorptiometry (DXA) at baseline. At follow-up two years later, 126 of the initial 144 patients were re-examined. BMD values are expressed as Z-scores. RESULTS:: Children with UC and CD had significantly lower mean BMD Z-scores of the lumbar spine (LS) at baseline and after two years. The reduction in BMD was equally pronounced in UC and CD patients, and neither group improved their Z-score during the follow-up period. Furthermore, significantly lower mean BMD Z-scores LS were found at baseline in males (-1.1 SD, ± 2.7 SD, p < 0.001), but not in females (-0.0 SD, ± 3.0 SD). This finding remained unchanged at follow-up. Subanalyses of the different age groups at baseline showed the lowest BMD values in the group of patients aged 17 to 19 years in males (mean Z-score LS -1.59 SD, ± 3.1 SD) and in females (mean Z-score LS -3.40 SD, ± 3.1 SD). However, at follow-up, these patients had improved their BMD significantly (mean change Z-score LS 1.00 SD, 95% CI 0.40-1.60; 1.90 SD, 95% CI 0.60-3.20). CONCLUSIONS:: In this longitudinal study, the entire group of pediatric IBD patients showed permanent decreases in their BMD Z-scores LS. However, our data indicate that afflicted children have the potential to improve their BMD by the time they reach early adulthood.

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