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Bone density in pediatric Crohn’s disease: A cross-sectional observation from South India

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Abstract

Background

Crohn’s disease (CD) frequently manifests in the second and third decades of life. Malnutrition and corticosteroid therapy may affect bone mineralization and delay bone growth. Our aim was to study bone mineral density and factors associated low bone mineral density (BMD) in pediatric CD.

Methods

A cross-sectional observational study in children with CD (aged 5 to <18 years) was done. Demographic and treatment details were noted. Vitamin D levels <20 ng/mL were considered as deficiency. Bone mineral density was evaluated with dual-energy X-ray absorptiometry (DEXA) scan and Z score of <−2 SD was considered as low BMD. Data was analyzed descriptively.

Results

In 30 cases with CD enrolled over 1 year, mean age of the patients was 13.8±3.0 years. Age of onset and diagnosis was 11.4±3.2 years and 13.4±2.8 years, respectively. 73.3% were in the underweight category. All cases received azathioprine whereas 86.7% were receiving corticosteroids. Vitamin D deficiency was seen in 86.7% cases. A low BMD was evident in 70% children. Overall, low BMI (p=0.005) and vitamin D deficiency (p=0.005) were associated with low BMD. However, no association between severity grade of vitamin D deficiency and low BMD was found. Treatment with corticosteroid was associated with low BMD in 76.9% cases (p=0.069).

Conclusion

Low BMD was frequent in children with CD and was associated with low BMI and vitamin D deficiency.

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Authors and Affiliations

  1. Department of Gastroenterology, Amrita Institute of Medical Sciences and Research Centre, Ponekkara P.O, Kochi, 682 041, India

    Shiraz Salim Khan & Sagar S. Patil

Authors
  1. Shiraz Salim Khan
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  2. Sagar S. Patil
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Correspondence to Shiraz Salim Khan.

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Conflict of interest

SSK, and SSP declare that they have no conflict of interest.

Ethical approval

All procedures in our study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.

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Khan, S.S., Patil, S.S. Bone density in pediatric Crohn’s disease: A cross-sectional observation from South India. Indian J Gastroenterol 36, 184–188 (2017). https://doi.org/10.1007/s12664-017-0751-7

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  • DOI: https://doi.org/10.1007/s12664-017-0751-7

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