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Arch Dis Child 1997;76:325-329 ( April )

Inflammatory bowel disease and predisposition to osteopenia

F J Cowan,a J T Warner,b F D J Dunstan,b W D Evans,a J W Gregory,b H R Jenkinsa

a University Hospital of Wales Healthcare NHS Trust, Cardiff, b University of Wales College of Medicine, Cardiff

Correspondence to: Dr F J Cowan, Department of Child Health, University Hospital of Wales, Heath Park, Cardiff CF4 4XW.

Accepted 13 December 1996

The prevalence of osteopenia in children with inflammatory bowel disease (IBD) is unknown. The effect of nutritional state, disease activity, and steroid therapy on bone mineral content (BMC) of whole body, lumbar spine, and left femoral neck measured by dual energy x ray absorptiometry in 32 children with IBD was assessed by comparison with 58 healthy local school children. Using the control data, a predicted BMC was calculated taking into account bone area, age, height, weight, and pubertal stage. The measured BMC in children with IBD was expressed as a percentage of this predicted value (% BMC). Mean (SD) % BMC was significantly reduced for the whole body and left femoral neck in the children with IBD (97.0 (4.5)% and 93.1 (12.0)% respectively, p<0.05). Of the children with IBD, 41% had a % BMC less than 1 SD below the mean for the whole body and 47% at the femoral neck. Reduction in % BMC was associated with steroid usage but not with the magnitude of steroid dose, disease activity, or biochemical markers of bone metabolism. In conclusion, osteopenia is relatively common in childhood IBD and may be partly related to the previous use of steroids.

Keywords: osteopenia; inflammatory bowel disease; bone mineral content

© 1997 by Archives of Disease in Childhood


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