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Risk Factors for Low Bone Mineral Density in Children and Adolescents with Inflammatory Bowel Disease

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Abstract

Objective To evaluate bone mineral density of the lumbar spine in children and adolescents with inflammatory bowel disease, and to identify the clinical risk factors associated with low bone mineral density. Methods Bone mineral density of the lumbar spine was evaluated using dual-energy X-ray absorptiometry (DXA) in 40 patients with inflammatory bowel disease. Patients were 11.8 (SD = 4.1) years old and most of them were male (52.5%). Multiple linear regression analysis was performed to identify potential associations between bone mineral density Z-score and age, height-for-age Z-score, BMI Z-score, cumulative corticosteroid dose in milligrams and in milligrams per kilogram, disease duration, number of relapses, and calcium intake according to the dietary reference intake. Results Low bone mineral density (Z-score bellow −2) was observed in 25% of patients. Patients with Crohn’s disease and ulcerative colitis had equivalent prevalence of low bone mineral density. Multiple linear regression models demonstrated that height-for-age Z-score, BMI Z-score, and cumulative corticosteroid dose in mg had independent effects on BMD, respectively, β = 0.492 (P = 0.000), β = 0.460 (P = 0.001), β = –0.014 (P = 0.000), and these effects remained significant after adjustments for disease duration, respectively, β = 0.489 (P = 0.013), β = 0.467 (P = 0.001), and β = −0.005 (P = 0.015). The model accounted for 54.6% of the variability of the BMD Z-score (adjusted R2 = 0.546). Conclusions The prevalence of low bone mineral density in children and adolescents with inflammatory bowel disease is considerably high and independent risk factors associated with bone mineral density are corticosteroid cumulative dose in milligrams, height-for-age Z-score, and BMI Z-score.

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Authors and Affiliations

  1. Division of Pediatric Gastroenterology, Universidade Federal de São Paulo – Escola Paulista de Medicina, São Paulo, Brazil

    Letícia Helena Caldas Lopes, Vera Lucia Sdepanian, Mauro Batista de Morais & Ulysses Fagundes-Neto

  2. Rua dos Otonis 880, apt 102, 04025-002, São Paulo, Brazil

    Vera Lucia Sdepanian

  3. Division of Rheumatology, Universidade Federal de São Paulo – Escola Paulista de Medicina, São Paulo, Brazil

    Vera Lúcia Szejnfeld

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  1. Letícia Helena Caldas Lopes
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  2. Vera Lucia Sdepanian
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  4. Mauro Batista de Morais
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  5. Ulysses Fagundes-Neto
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Correspondence to Vera Lucia Sdepanian.

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Lopes, L.H.C., Sdepanian, V.L., Szejnfeld, V.L. et al. Risk Factors for Low Bone Mineral Density in Children and Adolescents with Inflammatory Bowel Disease. Dig Dis Sci 53, 2746–2753 (2008). https://doi.org/10.1007/s10620-008-0223-0

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  • DOI: https://doi.org/10.1007/s10620-008-0223-0

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