Risk factors for low bone mineral density in children and adolescents with inflammatory bowel disease

Risk factors for low bone mineral density in children and adolescents with inflammatory bowel disease

Author Caldas Lopes, Leticia Helena Autor UNIFESP Google Scholar
Sdepanian, Vera Lucia Autor UNIFESP Google Scholar
Szejnfeld, Vera Lucia Autor UNIFESP Google Scholar
Morais, Mauro Batista de Autor UNIFESP Google Scholar
Fagundes-Neto, Ulysses Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Objective To evaluate bone mineral density of the lumbar spine in children and adolescents with inflammatory bowel disease, and to identify the clinical risk factors associated with low bone mineral density. Methods Bone mineral density of the lumbar spine was evaluated using dual-energy X-ray absorptiometry (DXA) in 40 patients with inflammatory bowel disease. Patients were 11.8 (SD = 4.1) years old and most of them were male (52.5%). Multiple linear regression analysis was performed to identify potential associations between bone mineral density Z-score and age, height-for-age Z-score, BMI Z-score, cumulative corticosteroid dose in milligrams and in milligrams per kilogram, disease duration, number of relapses, and calcium intake according to the dietary reference intake. Results Low bone mineral density (Z-score bellow -2) was observed in 25% of patients. Patients with Crohn's disease and ulcerative colitis had equivalent prevalence of low bone mineral density. Multiple linear regression models demonstrated that height-for-age Z-score, BMI Z-score, and cumulative corticosteroid dose in mg had independent effects on BMD, respectively, beta = 0.492 (P = 0.000), beta = 0.460 (P = 0.001), beta = -0.014 (P = 0.000), and these effects remained significant after adjustments for disease duration, respectively, beta = 0.489 (P = 0.013), beta = 0.467 (P = 0.001), and beta = -0.005 (P = 0.015). the model accounted for 54.6% of the variability of the BMD Z-score (adjusted R(2) = 0.546). Conclusions the prevalence of low bone mineral density in children and adolescents with inflammatory bowel disease is considerably high and independent risk factors associated with bone mineral density are corticosteroid cumulative dose in milligrams, height-for-age Z-score, and BMI Z-score.
Keywords bone mineral density
Crohn's disease
colitis
ulcerative
children
adolescents
multivariate analysis
Language English
Date 2008-10-01
Published in Digestive Diseases and Sciences. Dordrecht: Springer, v. 53, n. 10, p. 2746-2753, 2008.
ISSN 0163-2116 (Sherpa/Romeo, impact factor)
Publisher Springer
Extent 2746-2753
Origin http://dx.doi.org/10.1007/s10620-008-0223-0
Access rights Closed access
Type Article
Web of Science ID WOS:000258833800024
URI http://repositorio.unifesp.br/handle/11600/30940

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