Bone mineral density and nutritional status in children with chronic inflammatory bowel disease

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Abstract
Background—Osteoporosis has been reported in adult patients with inflammatory bowel disease. Aims—To evaluate bone mineral density (BMD), nutritional status, and determinants of BMD in children with inflammatory bowel disease. Patients—Fifty five patients (34 boys and 21 girls, age range 4–18) were studied; 22 had Crohn’s disease and 33 ulcerative colitis. Methods—Lumbar 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. Results—The mean SDS of lumbar spine BMD and total body BMD were significantly lower than normal (−0.75 and −0.95, both pr=−0.32, pr=0.36, pr=0.98). Conclusions—Children 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.