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- Schmidt, Susanne, 1970, et al.
(författare)
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Longitudinal Assessment of Bone Mineral Density in a Population of Children and Adolescents with Inflammatory Bowel Disease.
- 2012
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Ingår i: Journal of pediatric gastroenterology and nutrition. - 1536-4801. ; 55:5, s. 511-518
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES:: Low bone mineral density (BMD) is recognized as a potential problem in children with inflammatory bowel disease (IBD). We aimed to describe the longitudinal development of BMD in a population of Swedish pediatric patients with IBD. METHODS:: A total of 144 IBD patients (93 males; 83 with ulcerative colitis (UC), 45 with Crohn's disease (CD)) were examined with dual-energy X-ray absorptiometry (DXA) at baseline. At follow-up two years later, 126 of the initial 144 patients were re-examined. BMD values are expressed as Z-scores. RESULTS:: Children with UC and CD had significantly lower mean BMD Z-scores of the lumbar spine (LS) at baseline and after two years. The reduction in BMD was equally pronounced in UC and CD patients, and neither group improved their Z-score during the follow-up period. Furthermore, significantly lower mean BMD Z-scores LS were found at baseline in males (-1.1 SD,±2.7 SD, p<0.001), but not in females (-0.0 SD,±3.0 SD). This finding remained unchanged at follow-up. Subanalyses of the different age groups at baseline showed the lowest BMD values in the group of patients aged 17 to 19 years in males (mean Z-score LS -1.59 SD,±3.1 SD) and in females (mean Z-score LS -3.40 SD,±3.1 SD). However, at follow-up, these patients had improved their BMD significantly (mean change Z-score LS 1.00 SD, 95% CI 0.40-1.60; 1.90 SD, 95% CI 0.60-3.20). CONCLUSIONS:: In this longitudinal study, the entire group of pediatric IBD patients showed permanent decreases in their BMD Z-scores LS. However, our data indicate that afflicted children have the potential to improve their BMD by the time they reach early adulthood.
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