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KMID : 1100120230300010059
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대한골대사학회지
2023 Volume.30 No. 1 p.59 ~ p.68
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Bone Mineral Density in Patients with Pediatric Inflammatory Bowel Disease Using Dual Energy X-Ray Absorptiometry
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Isa Hasan M.
Ezzaldin Amira A.
Alabbasi Mohamed M.
ALaazm Noora H.
Masood Abdulrahman S.
Alabbasi Hissa M.
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Abstract
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Background: Inflammatory bowel disease (IBD) is a chronic inflammatory immune-mediated condition that affects the gastrointestinal system and alters bone growth and bone mineral density (BMD). Here we aimed to study the prevalence and predictors of a low BMD in pediatric patients with IBD.
Methods: This retrospective cross-sectional analytical study included pediatric patients with IBD in whom BMD was evaluated using dual energy X-ray absorptiometry of the total body and lumbar spine. Osteoporosis was defined as a BMD Z-score ≤-2, osteopenia as -2 to -1, and normal as >-1. Clinical and laboratory findings were compared between patients with and without osteoporosis.
Results: Of the 48 patients, 30 (62.5%) were males, 35 (72.9%) had Crohn’s disease, and 13 (27.1%) had ulcerative colitis. The mean age at diagnosis was 9.9±2.8 years. The median age at the time of the BMD scans was 11.9 (interquartile range, 9.9?14.3) years. Total body BMD scans identified 13 (27.1%) and 16 (33.3%) patients with osteoporosis and osteopenia, respectively. Spinal BMD scans revealed that 17 (39.5%) and 14 (32.6%) patients had osteoporosis and osteopenia, respectively. A low body mass index (BMI) Z-score (P=0.038), ileocolonic disease location (P=0.008), and a low calcium level (P=0.008) were significant predictors of osteoporosis on the total body BMD scans. A low BMI Z-score (P=0.039), decreased hemoglobin level (P=0.018), low calcium level (P=0.033), and infliximab use (P=0.019) were significant predictors of osteoporosis on the spinal BMD scans.
Conclusions: This study showed a high prevalence of low BMD among pediatric patients with IBD. A low BMI, ileocolonic disease location, low hemoglobin and calcium levels, and infliximab use were significantly associated with osteoporosis.
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KEYWORD
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Bahrain, Bone density, Inflammatory bowel diseases, Osteoporosis, Pediatrics
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