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Bone Mineral Density, Vitamin D, and Disease Activity in Children Newly Diagnosed with Inflammatory Bowel Disease

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Abstract

Background and Aim

The aim of this study was to examine bone mineral density and serum 25-hydroxy vitamin D in relation to disease activity in children newly diagnosed with IBD.

Methods

In a cross-sectional analytic study, 60 children newly diagnosed with IBD (39 with Crohn’s disease [CD], mean age 12.2 ± 2.1 years; and 21 with ulcerative colitis [UC], mean age 12.4 ± 3.7 years) were recruited. Fifty-six age- and sex-matched children without IBD were invited as controls (mean age 11.3 ± 4.2 years). Serum 25-hydroxy vitamin D for patients and controls was measured at diagnosis. Patients’ adjusted lumbar spine bone mineral density (BMD) z scores were measured. Activity indices for both CD and UC were calculated.

Results

The serum level of 25-hydroxy vitamin D was significantly lower in children with IBD compared to the control group (P = 0.04). BMD was significantly lower in patients with CD compared to those with UC (P = 0.039). There was no correlation between vitamin D levels, BMD z scores or disease activity indices for both CD and UC.

Conclusions

Serum vitamin D level is significantly lower in children with newly diagnosed IBD compared to those without. However, vitamin D levels are not affected by disease severity. It seems that BMD status may not be affected by vitamin D levels or disease severity in this cohort. Larger prospective controlled studies are needed to confirm these findings.

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References

  1. Boot AM, Bouquet J, Krenning EP, de Munick Keizer-Scharma SMPF. Bone mineral density and nutritional status in children with chronic inflammatory bowel disease. Gut. 1998;42:188–194.

    Article  CAS  PubMed  Google Scholar 

  2. Bernstein CN, Blanchard JF, Leslie W, et al. The incidence of fracture among patients with inflammatory bowel disease—a population-based cohort study. Ann Intern Med. 2000;133:795–799.

    CAS  PubMed  Google Scholar 

  3. Leslie WD, Miller N, Rogala L, et al. Vitamin D status and bone density in recently diagnosed inflammatory bowel disease: the Manitoba IBD cohort study. Am J Gastroenterol. 2008;103:1451–1459.

    Article  CAS  PubMed  Google Scholar 

  4. Gokhale R, Favus MJ, Karrison T, et al. Bone mineral density assessment in children with inflammatory bowel disease. Gastroenterology. 1998;114:902–911.

    Article  CAS  PubMed  Google Scholar 

  5. Lim WC, Hanauer SB, Li YC. Mechanism of disease: vitamin D and inflammatory bowel disease. Nat Clin Pract Gastroenterol Hepatol. 2005;2:308–315.

    Article  CAS  PubMed  Google Scholar 

  6. Loftus EV. Clinical epidemiology of inflammatory bowel disease: incidence, prevalence, and environmental influences. Gastroenterology. 2004;126:1504–1517.

    Article  PubMed  Google Scholar 

  7. Vogelsang H, Ferenci P, Woloszczuk W, et al. Bone disease in vitamin D-deficient patients with Crohn’s disease. Dig Dis Sci. 1989;34(7):1094–1099.

    Article  CAS  PubMed  Google Scholar 

  8. Ghosh S, Cowen S, Hannan WJ, et al. Low bone mineral density in Crohn’s disease, but not in ulcerative colitis, at diagnosis. Gastroenterology. 1994;107:1031–1039.

    CAS  PubMed  Google Scholar 

  9. Bischoff-Ferrari HA, Dietrich T, Orav EJ, et al. Positive association between 25-hydroxy vitamin D levels and bone mineral density: a population-based study of younger and older adults. Am J Med. 2004;116:634–639.

    Article  CAS  PubMed  Google Scholar 

  10. Hyams J, Markowitz J, Otley A, et al. Evaluation of the pediatric Crohn disease activity index: a prospective multicenter experience. J Pediatr Gastroenterol Nutr. 2005;41:416–422.

    Article  PubMed  Google Scholar 

  11. Turner D, Otley AR, Mack D, et al. Development, validation, and evaluation of a pediatric ulcerative colitis activity index: a prospective multicenter study. Gastroenterology. 2007;133:423–432.

    Article  PubMed  Google Scholar 

  12. Abitbol V, Roux C, Chaussade S, et al. Metabolic bone assessment in patients with inflammatory bowel disease. Gastroenterology. 1995;108:417–422.

    Article  CAS  PubMed  Google Scholar 

  13. Bernstein CN, Seeger LL, Sayre JW, et al. Decreased bone density in inflammatory bowel disease is related to corticosteroid use and not disease diagnosis. J Bone Miner Res. 1995;10:250–256.

    Article  CAS  PubMed  Google Scholar 

  14. Pappa HM, Gordon CM, Saslowsky TM, et al. Vitamin D status in children and young adults with inflammatory bowel disease. Pediatrics. 2006;118:1950–1961.

    Article  PubMed  Google Scholar 

  15. Sylvester FA, Wyzga N, Hyams JS, et al. Natural history of bone metabolism and bone mineral density in children with inflammatory bowel disease. Inflamm Bowel Dis. 2007;13:42–50.

    Article  PubMed  Google Scholar 

  16. Dubner SE, Shultz J, Baldassano RN, et al. Longitudinal assessment of bone density and structure in an incident cohort of children with Crohn’s disease. Gastroenterology. 2009;136:123–130.

    Article  PubMed  Google Scholar 

  17. Sentongo A, Semaeo EJ, Stettler N, et al. Vitamin D status in children, adolescents and young adults with Crohn disease. Am J Clin Nutr. 2002;76:1077–1081.

    CAS  PubMed  Google Scholar 

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Acknowledgments

The authors thank Dr. H. Huynh and the members of the Pediatric IBD program at the Stollery Children’s Hospital, Edmonton, Canada, for their help in facilitating data collection and clinical care of the patients.

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Correspondence to Wael El-Matary.

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El-Matary, W., Sikora, S. & Spady, D. Bone Mineral Density, Vitamin D, and Disease Activity in Children Newly Diagnosed with Inflammatory Bowel Disease. Dig Dis Sci 56, 825–829 (2011). https://doi.org/10.1007/s10620-010-1380-5

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  • DOI: https://doi.org/10.1007/s10620-010-1380-5

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