engleski

Assessment of bone metabolism in adolescents with inflammatory bowel disease – Preliminary report.

Skeletal integrity is challenged in paediatric patients with CB and UC due to several factors related to disease and treatment. In order to investigate bone metabolism. serum bone biochemical markers. 25-hydroxy vitamin D (25-OH D) and densitometry were performed in 30 children with CB and UC. This study comprised 13 boys and 17 girls. aged 8-17 years (14.1+/-2.4) ; 24 with diagnosis of CB and 6 with UC. Bone marker measurement included osteocalcin. procollagen-1 propeptide (P1CP) for bone formation. telopeptide collagen 1 crosslinks (crosslaps) for bone resorption. and 25-hydroxy vitamin D for assessment of vitamin D deficiency using commercial ELISA kits. Bone densitometry was performed at the lumbar spine (L1-L4 ???) and z-scores were used for evaluation. No difference between sexes existed for age. biochemical parameters or densitometry data. Vitamin D deficiency (<100 nmol/L) was found in most patients (18/21). Z-scores less than – 1 were found in 11/30 patients (-0.73+/-1.48. range – 3.95 – 2.47). Bone resorption marker was significantly higher in CB as compared to UC patients. but the two patient groups did not differ regarding other variables. Statistically significant negative correlation with age existed for bone markers and 25-OH D. Osteocalcin was positively correlated with P1CP and crosslaps. Bone markers were calculated as a ratio of reference limit for adults of the same sex demonstrating that the highest values were observed for crosslaps and P1CP. and less for osteocalcin. as compared to adult levels of the same marker. Our preliminary results indicate that osteopenia might be present in 30-40% and vitamin D deficiency in 80-90% of adolescent CB and UC patients. Negative correlation of 25-OH D with age might imply an additional challenge of bone metabolism in older children with CB and UC. Difference between patient groups was found only for increased bone resorption in CB. Bone turnover was increased as compared to adults. most pronounced for bone resorption and formation marker P1CP. Bone markers decreased with age as a consequence of growth completion. Measurement of bone markers and bone density in paediatric CB and UC patients as a part of follow-up might indicate metabolic bone disorder or changes in bone metabolism.

inflammatory bowel disease; adolescents; bone markers

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