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Prevalence and predictors of low bone mineral density in pediatric inflammatory bowel disease.

Sharmistha Rudra·Kanak Kennedy·Sarah Neukrug·Jing Huang·Diana L Cousminer·Amit Patel·Yuwen Xu·Struan F A Grant·Robert N Baldassano·Lindsey Albenberg·Babette S Zemel·Ronen Stein
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Abstract

OBJECTIVES: Bone health is at risk in children with inflammatory bowel disease (IBD). This study examined the prevalence and predictors of low bone mineral density (BMD) in a cohort of children and young adults with IBD. METHODS: This single-center retrospective study included patients with IBD, ages 3.5-22 years, with completed dual x-ray absorptiometry (DXA) scans from 2006 to 2019. Demographic, clinical, and laboratory data were collected. Logistic regression analysis identified predictors associated with low BMD (Z-scores&#x2009;&#x2264;&#x2009;-2 standard deviations [SDs]) for three outcomes. In an overlapping IBD cohort with available genetic data between 2002 and 2019 (n&#x2009;=&#x2009;378), genetic risk for diminished bone health was calculated using published polygenic risk scores generated from genome-wide association studies based on DXA or heel ultrasound speed of sound (SOS). Linear regression analysis examined associations of low BMD and genetic risk. RESULTS: Low BMD prevalence was 7% in our cohort (n&#x2009;=&#x2009;600) based on spine bone mineral apparent density (BMAD), which best accounts for growth delays. Median (interquartile range [IQR]) spine BMAD Z-score was -0.37&#x2009;SD (-1.11 to 0.35). Predictors of low BMAD included lower BMI Z-score (odds ratio [OR]: 0.67, p value: 0.02) and decreased height Z-score (OR: 0.6, p value: 0.005). Of those with longitudinal data (n&#x2009;=&#x2009;118), low BMI (OR: 0.44, p value: <0.001) and steroid use (OR: 3.42, p value: 0.01) were associated with suboptimal bone health (Z-scores&#x2009;&#x2264;&#x2009;-1SD). In the cohort with genetic data, heel genomic SOS (&#x3b2; [standard error] = 0.17 [0.35], p&#x2009;&#x2264;&#x2009;0.01) was associated with BMD. CONCLUSIONS: Lower BMI should prompt DXA monitoring in pediatric IBD. Genetic predisposition may identify an at-risk subpopulation.

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HumansChildFemaleAdolescentMaleRetrospective StudiesPrevalenceChild, PreschoolAbsorptiometry, PhotonInflammatory Bowel DiseasesBone DensityYoung AdultRisk FactorsBone Diseases, MetabolicCrohn diseaseDXAbone healthchildrenulcerative colitisJournal ArticleResearch Support, Non-U.S. Gov't

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Sharmistha Rudra, Kanak Kennedy, Sarah Neukrug, Jing Huang, Diana L Cousminer, Amit Patel, Yuwen Xu, Struan F A Grant, Robert N Baldassano, Lindsey Albenberg, Babette S Zemel, Ronen Stein. 2025-04-29. Prevalence and predictors of low bone mineral density in pediatric inflammatory bowel disease.. https://doi.org/10.1002/jpn3.70047

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