The abstract below was omitted from the abstracts from the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition annual meeting, May 9–12, 2007, Barcelona, Spain.
ASSESSMENT OF BONE METABOLISM IN ADOLESCENTS WITH INFLAMMATORY BOWEL DISEASE—PRELIMINARY REPORT ON 30 PATIENTS
Senecic-Cala I1, Kusec V2, Hojsak I3, Dujsin M4, Vukovic J5, Cvijetic S6, Kolacek S7
(1) University Hospital Centre Zagreb, Dept. of Pediatrics, Zagreb, CROATIA. (2) University Hospital Centre Zagreb Dept. of Medical Biochemistry, Zagreb, CROATIA. (3) Children's Hospital Zagreb, Dept. of Pediatrics, Zagreb, CROATIA. (4) University Hospital Centre Zagreb, Dept. of Pediatrics, Zagreb, CROATIA. (5) University Hospital Centre Zagreb, Dept. of Pediatrics, Zagreb, CROATIA. (6) Institute for Medical Research, Zagreb, CROATIA. (7) Children's Hospital Zagreb, Dept. of Pediatrics, Zagreb, CROATIA.
The authors report no conflicts of interest.
Aim: To investigate bone metabolism in adolescents with inflammatory bowel disease (IBD).
Methods: This study comprised 30 children, 13 boys and 17 girls, aged 8–17 years (14.1 ± 2.4); 24 with Crohn disease (CD) and 6 with ulcerative colitis (UC). Serum bone biochemical markers, 25-hydroxy vitamin D (25-OH D) and dual x-ray absorptiometry (DEXA) of lumbar spine were determined. Bone formation markers, osteocalcin and procollagen-1 propeptide (P1CP) and bone resorption marker, telopeptide collagen 1 crosslinks (crosslaps) were measured. DEXA of lumbar spine was expressed as z score.
Results: No difference between sexes existed for age, biochemical parameters, or densitometry data. Lower levels of vitamin D (<80 nmol/L) were found in 15/21 patients. z scores <−1 were found in 11/30 patients (−0.73 ± 1.48, range −3.95 to 2.47). Crosslaps were significantly higher in CD as compared to UC patients, but the 2 patient groups did not differ regarding other variables. Significant negative correlation with age existed for bone markers and 25-OH D. The highest values were observed for crosslaps and P1CP, and less for osteocalcin as compared to adult levels.
Discussion: Bone mineral density might be decreased in 30%–40% and insufficient levels of vitamin D in 70% of adolescents with IBD. Negative correlation of 25-OH D with age might imply an additional challenge of bone metabolism in older children with IBD. Bone resorption was increased in CD as compared to UC patients. Bone turnover was increased as compared to adults. Bone markers decreased with age as a consequence of growth completion.
Conclusions: Measurement of bone markers and bone density in adolescent IBD patients as a part of follow-up might indicate metabolic bone disorder or changes in bone metabolism.
1. Senecic-Cala I, Kusec V, Hojsak I, et al. Assessment of bone metabolism in adolescents with inflammatory bowel disease—preliminary report on 30 patients. J Pediatr Gastroenterol Nutr
2007; 44.(Suppl 1).