*Department of Pediatrics, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg and Queen Silvia Children's Hospital, Gothenburg, Sweden; †Premier Research LLC, Durham, North Carolina; ‡Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden; and §Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg and Geriatric Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
Inflamm Bowel Dis. 2017 Dec;23(12):2215-2226. doi: 10.1097/MIB.0000000000001277.
Children who have inflammatory bowel disease (IBD) have increased risk of low bone mineral density (BMD). There is a scarcity of information on BMD development through puberty and into young adulthood in patients with childhood-onset IBD.
We conducted a prospective longitudinal study of BMD in patients with childhood-onset IBD. In total, 74 children with IBD were followed into young adulthood, with a mean follow-up of 8.4 years. The BMD was assessed longitudinally using dual-energy X-ray absorptiometry of the lumbar spine, total hip and whole body, and related to anthropometric measures.
Young adult male patients with IBD had lower mean BMD Z-scores for the lumbar spine at -0.8 (±1.1 SD) and total hip at -0.5 (±0.9 SD), as compared to standard references. In young female patients, the BMD Z-scores were within the normal range at all 3 measured sites as compared to the standard references. There were no significant differences in the BMD Z-scores between patients with Crohn's disease and patients with ulcerative colitis. The female and male patients showed significantly improved mean lumbar spine BMD Z-scores during follow-up into young adulthood, indicating that bone accumulation in the lumbar spine continues beyond the expected age for achieving peak bone mass.
Male patients with childhood-onset IBD seem to have an increased risk of compromised BMD in young adulthood. Both female and male patients with IBD seem to increase their BMD beyond the age for expected peak bone mass (see Video abstract, Supplemental Digital Content 1, http://links.lww.com/IBD/B648).
患有炎症性肠病（IBD）的儿童骨密度（BMD）降低的风险增加。在儿童发病的 IBD 患者中，关于青春期和成年早期 BMD 发育的信息很少。
我们对儿童发病的 IBD 患者的 BMD 进行了前瞻性纵向研究。共有 74 名 IBD 患儿随访至成年早期，平均随访 8.4 年。通过腰椎、全髋和全身双能 X 射线吸收法对 BMD 进行纵向评估，并与人体测量指标相关联。
与标准参考值相比，患有 IBD 的成年男性患者的腰椎 BMDZ 评分平均为-0.8（±1.1SD），全髋 BMDZ 评分平均为-0.5（±0.9SD）。在年轻女性患者中，与标准参考值相比，3 个测量部位的 BMDZ 评分均在正常范围内。与溃疡性结肠炎患者相比，克罗恩病患者的 BMDZ 评分无显著差异。女性和男性患者在随访至成年早期时，腰椎 BMDZ 评分的平均值显著提高，表明腰椎骨量的积累在达到峰值骨量的预期年龄之后仍在继续。
儿童发病的 IBD 男性患者似乎有发生 BMD 降低的风险。无论男女，IBD 患者的 BMD 似乎都超过了预期的峰值骨量年龄（参见视频摘要，补充数字内容 1，http://links.lww.com/IBD/B648）。
