Department of Pediatrics, Institute of Clinical, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
J Pediatr Gastroenterol Nutr. 2012 Nov;55(5):511-8. doi: 10.1097/MPG.0b013e31825817a0.
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.
A total of 144 patients with IBD (93 males; 83 with ulcerative colitis [UC], 45 with Crohn disease [CD]) were examined with dual-energy x-ray absorptiometry at baseline. At follow-up 2 years later, 126 of the initial 144 patients were reexamined. BMD values are expressed as z scores.
Children with UC and CD had significantly lower mean BMD z scores for the lumbar spine (LS) at baseline and after 2 years. The reduction in BMD was equally pronounced in patients with UC and CD, and neither group improved their z score during the follow-up period. Furthermore, significantly lower mean BMD z scores for the LS were found at baseline in boys (-1.1 SD, ±2.7 SD, P < 0.001), but not in girls (-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 ages 17 to 19 years in boys (mean z score for the LS 1.59 SD, ±3.1 SD) and in girls (mean z score for the LS -3.40 SD, ±3.1 SD); however, at follow-up, these patients had improved their BMD significantly (mean change z score for the LS 1.00 SD, 95% CI 0.40-1.60; 1.90 SD, 95% CI 0.60-3.20).
In this longitudinal study, the entire group of pediatric patients with IBD showed permanent decreases in their BMD z scores for the LS; however, our data indicate that afflicted children have the potential to improve their BMD by the time they reach early adulthood.
低骨密度（BMD）被认为是炎症性肠病（IBD）患儿的潜在问题。本研究旨在描述瑞典儿科 IBD 患者的 BMD 纵向变化。
共纳入 144 例 IBD 患儿（93 例男性；93 例溃疡性结肠炎[UC]，45 例克罗恩病[CD]），基线时行双能 X 线吸收法骨密度检查。2 年后随访时，对初始 144 例患者中的 126 例进行复查。BMD 值以 z 评分表示。
UC 和 CD 患儿的腰椎（LS）BMD z 评分基线和 2 年后均显著降低。UC 和 CD 患儿的 BMD 降低幅度相同，且随访期间两组的 z 评分均未改善。此外，男孩的 LS 平均 BMD z 评分在基线时显著较低（-1.1 SD，±2.7 SD，P < 0.001），而女孩则没有（-0.0 SD，±3.0 SD）。随访时结果仍相似。对基线不同年龄组的亚组分析显示，男孩和女孩中年龄为 17 至 19 岁的患者组的 BMD 值最低（LS 的平均 z 评分，男孩为 1.59 SD，±3.1 SD；女孩为-3.40 SD，±3.1 SD）；然而，在随访时，这些患者的 BMD 显著改善（LS 的平均 z 评分变化，男孩为 1.00 SD，95%CI 0.40-1.60；女孩为 1.90 SD，95%CI 0.60-3.20）。
在这项纵向研究中，所有 IBD 儿科患者的 LS BMD z 评分均持续降低；然而，我们的数据表明，这些患者在成年早期有改善 BMD 的潜力。
