Longitudinal changes in bone mineral density in children with inflammatory bowel diseases

Yael Levy-Shraga*, Anatoly Shenkar, Dalit Modan-Moses, Amit Assa, Yael Haberman, Dror Shouval, Anat Guz-Mark, Avishay Lahad, Batia Weiss

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Aim: Children with inflammatory bowel disease (IBD) are prone to low bone mineral density (BMD). Our aim was to assess longitudinal changes in BMD in this population. Methods: A retrospective longitudinal study of children with IBD, treated at two tertiary centres in Israel, who underwent two BMD measurements by dual-energy X-ray absorptiometry (DXA). Changes in lumbar spine BMD (∆L1-4 z-scores) were examined for correlations with clinical characteristics. Results: The cohort included 41 patients (age at diagnosis 12.1 ± 3.5 years, 23 females).The mean interval between the scans was 3.4 ± 2.0 years. There was a trend towards improvement in L1-4 z-scores (−1.64 ± 1.02 vs −1.45 ± 0.83, P =.12). ∆L1-4 z-scores correlated positively with ∆weight-standard deviation scores (SDS), ∆height-SDS and ∆BMI-SDS, and with age at the second scan (R =.55, P <.01; R =.42, P <.01; R =.42, P =.01; R =.35, P =.02, respectively); and negatively with L1-4 z-scores at the first scan (R = −.63, P <.01). Stepwise linear regression analysis identified the first scan L1-4 z-scores and ∆weight-SDS as independent predictors of ∆L1-4 z-scores. An L1-4 z-score ≤−2 at the first DXA scan was associated with significant improvement at the second scan. Conclusion: Improvement in BMD was more pronounced in children who gained weight or whose BMD was low at the first scan.

Original languageEnglish
Pages (from-to)1026-1032
Number of pages7
JournalActa Paediatrica, International Journal of Paediatrics
Issue number5
StatePublished - 1 May 2020


  • Crohn's disease
  • bone
  • bone mineral density
  • dual-energy X-ray absorptiometry
  • ulcerative colitis


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