Khan Shiraz Salim, Patil Sagar S
Department of Gastroenterology, Amrita Institute of Medical Sciences and Research Centre, Ponekkara P.O, Kochi, 682 041, India.
Indian J Gastroenterol. 2017 May;36(3):184-188. doi: 10.1007/s12664-017-0751-7. Epub 2017 Jun 20.
Crohn's disease (CD) frequently manifests in the second and third decades of life. Malnutrition and corticosteroid therapy may affect bone mineralization and delay bone growth. Our aim was to study bone mineral density and factors associated low bone mineral density (BMD) in pediatric CD.
A cross-sectional observational study in children with CD (aged 5 to <18 years) was done. Demographic and treatment details were noted. Vitamin D levels <20 ng/mL were considered as deficiency. Bone mineral density was evaluated with dual-energy X-ray absorptiometry (DEXA) scan and Z score of <-2 SD was considered as low BMD. Data was analyzed descriptively.
In 30 cases with CD enrolled over 1 year, mean age of the patients was 13.8±3.0 years. Age of onset and diagnosis was 11.4±3.2 years and 13.4±2.8 years, respectively. 73.3% were in the underweight category. All cases received azathioprine whereas 86.7% were receiving corticosteroids. Vitamin D deficiency was seen in 86.7% cases. A low BMD was evident in 70% children. Overall, low BMI (p=0.005) and vitamin D deficiency (p=0.005) were associated with low BMD. However, no association between severity grade of vitamin D deficiency and low BMD was found. Treatment with corticosteroid was associated with low BMD in 76.9% cases (p=0.069).
Low BMD was frequent in children with CD and was associated with low BMI and vitamin D deficiency.
克罗恩病（CD）常在人生的第二个和第三个十年出现。营养不良和皮质类固醇治疗可能会影响骨矿化并延缓骨骼生长。我们的目的是研究儿童CD患者的骨密度及与低骨密度（BMD）相关的因素。
对5至<18岁的CD患儿进行了一项横断面观察性研究。记录了人口统计学和治疗细节。维生素D水平<20 ng/mL被视为缺乏。采用双能X线吸收法（DEXA）扫描评估骨密度，Z值<-2 SD被视为低骨密度。对数据进行描述性分析。
在1年多时间里纳入的30例CD患者中，患者的平均年龄为13.8±3.0岁。发病年龄和诊断年龄分别为11.4±3.2岁和13.4±2.8岁。73.3%属于体重过轻类别。所有病例均接受硫唑嘌呤治疗，而86.7%正在接受皮质类固醇治疗。86.7%的病例存在维生素D缺乏。70%的儿童骨密度较低。总体而言，低体重指数（p=0.005）和维生素D缺乏（p=0.005）与低骨密度相关。然而，未发现维生素D缺乏严重程度等级与低骨密度之间存在关联。76.9%的病例中，皮质类固醇治疗与低骨密度相关（p=0.069）。
CD患儿中低骨密度很常见，且与低体重指数和维生素D缺乏有关。
