Bone Health in Pediatric Patients With Crohn's Disease

OBJECTIVE The aim of our study was to examine longitudinal changes in bone mineral density (BMD) of children and adolescents with Crohn's disease, and risk factors related to low BMD. PATIENTS AND METHODS All patients aged from 2 to 18 years with CD who underwent dual-energy X-ray absorptiometry (DXA) at diagnosis and at the end of follow-up between 1999 and 2018 were considered for inclusion in this retrospective study. Factors related to changes in BMD at diagnosis and during follow-up were investigated. RESULTS 193 patients had the 2 DXA required.At diagnosis 36 patients (18.7%) had a low BMD.At the end of follow-up, 31 patients (16%).164 patients did not have the 2 DXA required.In included CD, BMD values were lower in lumbar spine (LS) than in total body less head (TBLH), as well at diagnosis (p < 0.0001) or at the end of follow-up (p = 0.001).At diagnosis, only growth impairment or low BMI was associated with low BMD (p < 0.0001), only cumulative dose of corticosteroid at the end of follow-up (p = 0.01). CONCLUSION The high prevalence of low BMD in children and adolescents with IBD highlights the importance of evaluating BMD in these patients at the time of diagnosis and throughout the course of their treatment. Special attention must be given to patients with height delay or low BMI at diagnosis. Long-term glucocorticoid therapy is the main clinical risk factor associated with low BMD at the end of follow-up.