Semeao E J, Jawad A F, Zemel B S, Neiswender K M, Piccoli D A, Stallings V A
Department of Pediatrics, Children's Hospital of Philadelphia, PA 19104-4399, USA.
Inflamm Bowel Dis. 1999 Aug;5(3):161-6. doi: 10.1097/00054725-199908000-00003.
Reduced bone mineral density (BMD) has been reported in adults with Crohn's disease (CD). Less is known about abnormal BMD in children and young adults with CD. The aims of this study are to determine the prevalence of low BMD and to evaluate the effect of growth and pubertal development on BMD in children and young adults with CD. One hundred-nineteen patients with CD underwent dual-energy X-ray absorptiometry (DXA) to determine BMD. Anthropometry and pubertal development were measured. Bone age was measured only in patients older than 8 years of age and who had not grown in height during the last year. One hundred-nineteen patients (72 male, 47 female) were evaluated. Seventy percent of patients had BMD z-scores < or = -1.0 and 32% had z-scores < or = -2.0. Weight and height z-scores were significantly associated with BMD z-scores. BMD z-scores based on bone age and on chronological age were highly correlated, except when the chronological age BMD z-score was < or = -2.0. BMD z-score was significantly different between males and females for the group (-1.75 +/- 1.06 vs. -1.08 +/- 1.00), respectively. Children and young adults with CD have a high prevalence of low BMD and routine evaluation by DXA is indicated. In patients with a chronological age-based BMD z-score < or = -2.0, a bone age-based BMD should be considered.
据报道，克罗恩病（CD）成年患者存在骨矿物质密度（BMD）降低的情况。对于患有CD的儿童和青年，骨密度异常的情况则鲜为人知。本研究的目的是确定低骨密度的患病率，并评估生长和青春期发育对患有CD的儿童和青年骨密度的影响。119例CD患者接受了双能X线吸收测定法（DXA）以确定骨密度。测量了人体测量学指标和青春期发育情况。仅对年龄超过8岁且过去一年身高未增长的患者测量了骨龄。对119例患者（72例男性，47例女性）进行了评估。70%的患者骨密度z评分≤ -1.0，32%的患者z评分≤ -2.0。体重和身高z评分与骨密度z评分显著相关。基于骨龄和实际年龄的骨密度z评分高度相关，但实际年龄骨密度z评分≤ -2.0时除外。该组男性和女性的骨密度z评分有显著差异（分别为-1.75±1.06和-1.08±1.00）。患有CD的儿童和青年低骨密度的患病率很高，因此建议通过DXA进行常规评估。对于实际年龄骨密度z评分≤ -2.0的患者，应考虑基于骨龄的骨密度。
