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Evaluation of Bone Densitometry Parameters in Children with Inflammatory Bowel Disease

Document Type : original article

Authors

1 Department of pediatrics, Mashhad University of medical sciences, Mashhad, Iran.

2 Department of Pediatrics, Faculty of medicine, Mashhad university of medical sciences, Mashhad, Iran

3 Department of Pediatric Gastroenterology, akbar children hospital, Mashhad University of medical sciences, Mashhad, Iran.

4 Department of Pediatric Gastroenterology, Akbar Children Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.

5 Associate Professor, Nuclear Medicine Research Center, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran

6 Department of Community Medicine, Faculty Of Medicine , Mashhad Medical Sciences, Islamic Azad University, Mashhad, Iran.

Abstract

Background: The present study was performed to assess densitometry indices in pediatric patients affected by Inflammatory Bowel Disease (IBD) in Mashhad city, east of Iran.
Methods: Seventy pediatric IBD patients (8-18 age range) in Akbar Hospital in Mashhad were evaluated in terms of clinical parameters (age, sex, weight, height, IBD type, IBD activity, duration of disease, affected organ, management methods, treatment duration, hospitalization time, nutritional status and puberty), laboratory parameters (serum levels of vitamin D, albumin (Alb), calcium (Ca), phosphorous (P), sodium (Na), magnesium (Mg), Urea, creatinine (Cr) along with important hepatic enzymes aspartate aminotransferase (AST), alanine transaminase (ALT) and alkaline phosphatase (ALP)). Also, Dual-energy X-ray Absorptiometry (DXA) was applied for whole body and lumbar spine Bone Mineral Density (BMD) measurement.
Results and conclusion: IBD was mostly manifested as ulcerative colitis (UC) (62.9%) and the disease duration and treatment course were mostly reported to be "over 6 months", with 88.6% and 84.3%, respectively. Most patients had normal (n = 43; 61.4%) and decreased (n = 20; 28.6%) nutritional status, sorted in tanner stage 4 (n = 40; 57.1%), had no hospitalization (81.4%), and received prednisolone (n = 33; 47.1%). Moreover, left colitis (n = 39; 55.7%) and pan colitis (n = 24; 34.3%) were the most affected parts. No statistically significant correlation was reported regarding lumbar BMD values in terms of gender, disease duration, treatment time, and IBD type. Also, there was no statistical association between the treatment type and involved tissues with lumbar and femoral BMD values among 70 examined children in the present study. Still, more studies are recommended to truly evaluate the bone densitometry parameters in children with inflammatory bowel disease.

Keywords

References
  1. Park JH, Peyrin-Biroulet L, Eisenhut M, Shin JI. IBD immunopathogenesis: a comprehensive review of inflammatory molecules. Autoimmunity reviews. 2017; 16(4):416-26.
  2. Rosen MJ, Dhawan A, Saeed SA. Inflammatory bowel disease in children and adolescents. JAMA pediatrics. 2015; 169(11):1053-60.
  3.  Breton J, Kastl A, Conrad MA, Baldassano RN. Positioning biologic therapies in the management of pediatric inflammatory bowel disease. Gastroenterology & Hepatology. 2020; 16(8):400
  1. Santos MPC, Gomes C, Torres J. Familial and ethnic risk in inflammatory bowel disease. Annals of gastroenterology. 2018; 31(1):14.
  2. Guan Q. A comprehensive review and update on the pathogenesis of inflammatory bowel disease. Journal of immunology research. 2019; 2019.
  3. Bravenboer N, Oostlander AE, Van Bodegraven AA. Bone loss in patients with inflammatory bowel disease: Cause, detection and treatment. Current Opinion in Gastroenterology. 2021; 37(2):128-34
  4. Arvikar SL, Fisher MC. Inflammatory bowel disease associated arthropathy. Current reviews in musculoskeletal medicine. 2011; 4:123-31.
  5. Sanderson IR. Growth problems in children with IBD. Nature reviews Gastroenterology & hepatology. 2014; 11(10):601-10.
  6. Isa HM, Ezzaldin AA, Alabbasi MM, NH AL, Masood AS, Alabbasi HM. Bone Mineral Density in Patients with Pediatric Inflammatory Bowel Disease Using Dual Energy X-Ray Absorptiometry. Journal of bone metabolism. 2023; 30(1):59-68.
  7. Delmas PD. Bone mass measurement: how, where, when and why? International journal of fertility and menopausal studies. 1993; 38 Suppl 2:70-6.
  8. Wasserman H, O'Donnell JM, Gordon CM. Use of dual energy X-ray absorptiometry in pediatric patients. Bone. 2017; 104:84-90.
  9. Laakso S, Valta H, Verkasalo M, Toiviainen-Salo S, Viljakainen H, Mäkitie O. Impaired bone health in inflammatory bowel disease: a case–control study in 80 pediatric patients. Calcified Tissue International. 2012; 91:121-30.
  10. Nobile S, Grand RJ, Pappa HM. Risk factors for low bone mineral density in pediatric inflammatory bowel disease: the positive role of physical activity. European Journal of Gastroenterology & Hepatology. 2018; 30(4):471-6.
  11. Schmidt S, Mellström D, Norjavaara E, Sundh VS, Saalman R. Low bone mineral density in children and adolescents with inflammatory bowel disease: a population-based study from Western Sweden. Inflammatory bowel diseases. 2009; 15(12):1844-50.
  12. Schoon EJ, Blok BM, Geerling BJ, Russel MG, Stockbrügger RW, Brummer RJM. Bone mineral density in patients with recently diagnosed inflammatory bowel disease. Gastroenterology. 2000; 119(5):1203-8.
  13. Shoaee S, Saeedi Moghaddam S, Masinaei M, Sofi-Mahmudi A, Hessari H, Heydari M-H, Shamsoddin E, Parsaeian M, Ghasemian A, Larijani B, Fakhrzadeh H, Farzadfar F. Trends in dental caries of deciduous teeth in Iran: a systematic analysis of the national and sub-national data from 1990 to 2017. BMC Oral Health. 2022; 22(1):634.
  14. Mortazavi H, Sadeghian A, Hazrati P, Heydari M-H, Madihi S. Oral hemorrhagic blister and its possible related factors: Analyses of reported cases in the literature. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology. 2023.
  15. Silvennoinen J, Karttunen T, Niemelä S, Manelius J, Lehtola J. A controlled study of bone mineral density in patients with inflammatory bowel disease. Gut. 1995; 37(1):71-6.
  16. Tulewicz-Marti EM, Lewandowski K, Rydzewska G. Bone Metabolism Alteration in Patients with Inflammatory Bowel Disease. Journal of Clinical Medicine. 2022; 11(14):4138.
  17. Lopes LHC, Sdepanian VL, Szejnfeld VL, de Morais MB, Fagundes-Neto U. Risk factors for low bone mineral density in children and adolescents with inflammatory bowel disease. Digestive diseases and sciences. 2008; 53:2746-53.
  18. Sznurkowska K, Żawrocki A, Sznurkowski J, Zieliński M, Landowski P, Plata-Nazar K, Iżycka-Świeszewska E, Trzonkowski P, Szlagatys-Sidorkiewicz A, Kamińska B. Peripheral and Intestinal T-regulatory Cells are Upregulated in Children with Inflammatory Bowel Disease at Onset of Disease. Immunological investigations. 2016; 45(8):787-96.

    Journal of Pediatric Endocrinology and Metabolism. 2006; 19(3):213-22.

    1. Sadat-Ali M, Mattar ME. Osteoporosis among Bahraini citizens: The first report. International Journal of Applied and Basic Medical Research. 2020; 10(3):164.
    2. AlSayyad A, AlAjmi A, Naseeb T. Prevalence and risk factors of osteoporosis in Bahrain: A cross-sectional study among young female attending primary care centers. J Bahrain Med Soc. 2021; 33(33):22-8.
    3. Schmidt S, Mellström D, Norjavaara E, Sundh V, Saalman R. Longitudinal assessment of bone mineral density in children and adolescents with inflammatory bowel disease. Journal of pediatric gastroenterology and nutrition. 2012; 55(5):511-8.
    4. Saadah OI, Annese V, Mosli MH. Prevalence and Predictors of Reduced Bone Density in Child and Adolescent Patients with Crohn's Disease. Journal of Clinical Densitometry. 2021; 24(2):252-8.
    5. Moscowchi A, Moradian-Lotfi S, Koohi H, Sarrafan Sadeghi T. Levels of smoking and outcome measures of root coverage procedures: a systematic review and meta-analysis. Oral Maxillofac Surg. 2023.
    6. Setty-Shah N, Maranda L, Nwosu BU. Adiposity is associated with early reduction in bone mass in pediatric inflammatory bowel disease. Nutrition. 2016; 32(7-8):761-6.
    7. Shoaee S, Masinaei M, Moghaddam SS, Sofi-Mahmudi A, Hessari H, Shamsoddin E, Heydari MH, Larijani B, Fakhrzadeh H, Farzadfar F. National and Subnational Trend of Dental Caries of Permanent Teeth in Iran, 1990–2017. International Dental Journal. 2023.
    8. Sohn J, Chang EJ, Yang HR. Vitamin D status and bone mineral density in children with inflammatory bowel disease compared to those with functional abdominal pain. Journal of Korean Medical Science. 2017; 32(6):961-7.
    9. Levy‐Shraga Y, Shenkar A, Modan‐Moses D, Assa A, Haberman Y, Shouval D, Guz-Mark A, Lahad A, Weiss B. Longitudinal changes in bone mineral density in children with inflammatory bowel diseases. Acta Paediatrica. 2020; 109(5):1026-32.
    10. Herzog D, Bishop N, Glorieux F, Seidman EG. Interpretation of bone mineral density values in pediatric Crohn's disease. Inflammatory Bowel Diseases. 1998; 4(4):261-7.
    11. Shoaee S, Rezaie F, Payab M, Bakhtiari F, Heydari M-H. Experiences from the management of the COVID-19 pandemic in a nursing home in Iran (March–April, 2020). Journal of Diabetes & Metabolic Disorders. 2022; 21(1):1195-9.
    12. Maratova K, Hradsky O, Matyskova J, Copova I, Soucek O, Sumnik Z, Bronsky J. Musculoskeletal system in children and adolescents with inflammatory bowel disease: normal muscle force, decreased trabecular bone mineral density and low prevalence of vertebral fractures. European Journal of Pediatrics. 2017; 176:1355-63.
    13. El-Matary W, Sikora S, Spady D. Bone mineral density, vitamin D, and disease activity in children newly diagnosed with inflammatory bowel disease. Digestive diseases and sciences. 2011; 56:825-9.
    14. Sofi-Mahmudi A, Masinaei M, Shamsoddin E, Tovani-Palone MR, Heydari M-H, Shoaee S, Ghasemi E, Azadnajafabad S, Roshani S, Rezaei N, Rashidi MM, Mehrjardi RK, Hajebi AA, Larijani B, Farzadfar F. Global, regional, and national burden and quality of care index (QCI) of lip and oral cavity cancer: a systematic analysis of the Global Burden of Disease Study 1990–2017. BMC Oral Health. 2021; 21(1):1-11.
International Journal of Pediatrics
Volume 11, Issue 9
September 2023
Pages 18246-18256
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