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. 2021 Jan 14;21(1):35.
doi: 10.1186/s12887-021-02496-4.

Growth, puberty, and bone health in children and adolescents with inflammatory bowel disease

Hye-Young Jin  1 , Jae-Sang Lim  2 , Yena Lee  2 , Yunha Choi  2 , Seak-Hee Oh  2 , Kyung-Mo Kim  2 , Han-Wook Yoo  2 , Jin-Ho Choi  3
Affiliations

Growth, puberty, and bone health in children and adolescents with inflammatory bowel disease

Hye-Young Jin et al. BMC Pediatr. .

Abstract

Background: Endocrine complications such as impaired growth, delayed puberty, and low bone mineral density (BMD) can be associated with inflammatory bowel disease (IBD) in children and adolescents. This study was performed to investigate the frequency, characteristics, and outcomes of endocrine complications of IBD in children and adolescents.

Methods: This study included 127 patients with IBD diagnosed before 18 years of age [117 with Crohn disease (CD) and 10 with ulcerative colitis (UC)]. Growth profiles, pubertal status, 25-hydroxyvitamin D3 [25(OH)D3] levels, and BMD were reviewed retrospectively.

Results: Short stature was observed in 14 of 127 (11.0 %) with a mean height-SDS of -2.31 ± 0.72. During a 2-year follow-up period, height-SDS did not significantly improve, while weight-SDS significantly improved. Among 109 patients who were older than 13 (girls) or 14 (boys) years of age during the study period, 11 patients (10.1 %) showed delayed puberty, which was associated with low weight-SDS. Vitamin D deficiency was documented in 81.7 % (94/115) with the average 25(OH)D3 level of 14.5 ± 7.0 ng/mL. Lumbar BMD Z-score was below - 2 SDS in 25 of 119 patients (21.0 %). Height-SDS, weight-SDS, and body mass index (BMI)-SDS were lower in patients with osteoporosis than those without osteoporosis. When pediatric CD activity index scores were high (≥ 30), weight-SDS, BMI-SDS, insulin-like growth factor 1 (IGF-1)-SDS, and testosterone levels were significantly decreased.

Conclusions: Vitamin D deficiency and osteoporosis are common in pediatric IBD patients. As disease severity deteriorates, weight-SDS, IGF-1-SDS, and testosterone levels were decreased. Optimal pubertal development is necessary for bone health.

Keywords: Bone mineral density; Crohn disease; Growth; Inflammatory bowel disease; Puberty; Ulcerative colitis.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Trends of height-SDS and weight-SDS of patients over two years of treatment a Trend of height-SDS b Trend of weight-SDS
See this image and copyright information in PMC

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