Department of Pediatrics, Center for Pediatric Cancer, National Cancer Center, Goyang, Gyeonggi-do, Republic of Korea.
Department of Pediatrics, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, 05505, Seoul, Republic of Korea.
BMC Pediatr. 2021 Jan 14;21(1):35. doi: 10.1186/s12887-021-02496-4.
Endocrine complications such as impaired growth, delayed puberty, and low bone mineral density (BMD) can be associated with inflammatory bowel disease (IBD) in children and adolescents. This study was performed to investigate the frequency, characteristics, and outcomes of endocrine complications of IBD in children and adolescents.
This study included 127 patients with IBD diagnosed before 18 years of age [117 with Crohn disease (CD) and 10 with ulcerative colitis (UC)]. Growth profiles, pubertal status, 25-hydroxyvitamin D [25(OH)D] levels, and BMD were reviewed retrospectively.
Short stature was observed in 14 of 127 (11.0 %) with a mean height-SDS of -2.31 ± 0.72. During a 2-year follow-up period, height-SDS did not significantly improve, while weight-SDS significantly improved. Among 109 patients who were older than 13 (girls) or 14 (boys) years of age during the study period, 11 patients (10.1 %) showed delayed puberty, which was associated with low weight-SDS. Vitamin D deficiency was documented in 81.7 % (94/115) with the average 25(OH)D level of 14.5 ± 7.0 ng/mL. Lumbar BMD Z-score was below - 2 SDS in 25 of 119 patients (21.0 %). Height-SDS, weight-SDS, and body mass index (BMI)-SDS were lower in patients with osteoporosis than those without osteoporosis. When pediatric CD activity index scores were high (≥ 30), weight-SDS, BMI-SDS, insulin-like growth factor 1 (IGF-1)-SDS, and testosterone levels were significantly decreased.
Vitamin D deficiency and osteoporosis are common in pediatric IBD patients. As disease severity deteriorates, weight-SDS, IGF-1-SDS, and testosterone levels were decreased. Optimal pubertal development is necessary for bone health.
儿童和青少年的炎症性肠病（IBD）可能会导致内分泌并发症，如生长受损、青春期延迟和骨密度（BMD）降低。本研究旨在调查儿童和青少年 IBD 内分泌并发症的频率、特征和结局。
本研究纳入了 127 名 18 岁以下确诊为 IBD 的患者[117 名克罗恩病（CD）和 10 名溃疡性结肠炎（UC）]。回顾性分析了生长曲线、青春期状态、25-羟维生素 D [25(OH)D]水平和 BMD。
127 例患者中有 14 例（11.0%）存在身材矮小，平均身高标准差评分（height-SDS）为-2.31±0.72。在 2 年的随访期间，身高 SDS 没有显著改善，而体重 SDS 显著改善。在研究期间年龄大于 13 岁（女孩）或 14 岁（男孩）的 109 名患者中，有 11 名（10.1%）出现青春期延迟，与体重 SDS 较低有关。115 例患者中有 81.7%（94/115）存在维生素 D 缺乏，平均 25(OH)D 水平为 14.5±7.0ng/ml。119 例患者中有 25 例（21.0%）腰椎 BMD Z 评分低于-2 SDS。骨质疏松症患者的身高 SDS、体重 SDS 和 BMI-SDS 均低于非骨质疏松症患者。当小儿 CD 活动指数评分较高（≥30）时，体重 SDS、BMI-SDS、胰岛素样生长因子 1（IGF-1）-SDS 和睾酮水平显著降低。
维生素 D 缺乏和骨质疏松症在小儿 IBD 患者中较为常见。随着疾病严重程度的恶化，体重 SDS、IGF-1-SDS 和睾酮水平降低。最佳的青春期发育对于骨骼健康是必要的。
