ESPE Abstracts (2019) 92 P2-40

Reduced Bone Mineral Density in Children with Inflammatory Bowel Disease without Exposure to Corticosteroid Treatment

Marina Mitrogiorgou1, Feneli Karachaliou1, Nikitas Skarakis1, Aristophania Simatou1, Melpomeni Peppa2, Smaragdi Fessatou1, Vassiliki Papaevangelou1


1Pediatric Endocrinology Unit, 3rd University Department of Pediatrics, Attikon University Hospital, Athens, Greece. 2Endocrinology Clinic, 4th Dept of Internal Medicine, Attikon University Hospital, Athens, Greece


Objectives: Bone mineral density is reduced in children and adolescents with inflammatory bowel disease (IBF). The exact cause of this reduction is not known and is often attributed to corticosteroid use. The aim of the study was to evaluate bone mineral density in children with IBF without previous corticosteroid exposure.

Methods: Twelve children aged 8-17years with IBF (8 with Crohn's disease and 4 with ulcerative colitis) underwent dual-energy x-ray absorptiometry (DEXA). Data on growth and pubertal development, disease activity, and calcium metabolism were recorded. Bone mass measurements were performed and z-scores were adjusted for bone age.

Results: Four of the 12 patients (33.3%) had lumbar spine bone mineral density z score less than -1 (three had a z score less than -2). The same percentage (33.3%) of children had total bone mineral density z scores less than -1 (two had z score less than -2). The subjects with IBF had significantly reduced mean lumbar spine bone mineral density z-scores (P = 0.01) and most of them had delayed puberty. 40% of children had 25OHvitD levels ≤20ng/ml. There was not any association between bone density and children's auxological data or 25OHvitD levels.

Conclusion: A reduction of bone mineral density is common in children and adolescents with IBF. The inflammatory disease contributes to impaired bone mass and delayed puberty may constitute one of the mechanisms

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