Bone health in children with inflammatory bowel disease : adjusting for bone age

Hill, R. J., Brookes, D. S. K., Lewindon, P. J., Withers, G. D., Ee, L. C., Connor, F. L., Cleghorn, Geoffrey J., & Davies, P. S. W. (2009) Bone health in children with inflammatory bowel disease : adjusting for bone age. Journal of Pediatric Gastroenterology and Nutrition, 48(5), pp. 538-543.

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OBJECTIVES: Clinical results of bone mineral density for children with inflammatory bowel disease are commonly reported using reference data for chronological age. It is known that these children, particularly those with Crohn disease, experience delayed growth and maturation. Therefore, it is more appropriate to compare clinical results with bone age rather than chronological age. MATERIALS AND METHODS: Areal bone mineral density (aBMD) was measured using dual energy x-ray absorptiometry, and bone age was assessed using the Tanner-Whitehouse 3 method from a standard hand/wrist radiograph. Results were available for 44 children ages 7.99 to 16.89 years. Areal bone mineral density measurements were converted to z scores using both chronological and bone ages for each subject. RESULTS: Areal bone mineral density z scores calculated using bone age, as opposed to chronological age, were significantly improved for both the total body and lumbar spine regions of interest. When subjects were grouped according to diagnosis, bone age generated z scores remained significantly improved for those with Crohn disease but not for those diagnosed with ulcerative colitis. Grouping of children with Crohn disease into younger and older ages produced significantly higher z scores using bone age compared with chronological for the older age group, but not the younger age group. CONCLUSIONS: Our findings, in accordance with those presented in the literature, suggest that aBMD results in children with Crohn disease should include the consideration of bone age, rather than merely chronological age. Bone size, although not as easily available, would also be an important consideration for interpreting results in paediatric populations. © 2009 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

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ID Code: 89190
Item Type: Journal Article
Refereed: Yes
Additional Information: Cited By :13 Export Date: 1 September 2015 CODEN: JPGND Correspondence Address: Hill, R. J.; Children's Nutrition Research Centre, University of Queensland, Royal Children's Hospital, Herston, QLD 4029, Australia; email:
Keywords: Bone age, Bone mineral density, Crohn disease, Dual energy x-ray absorptiometry, Ulcerative Colitis, adolescent, age distribution, article, bone density, child, clinical article, dual energy X ray absorptiometry, female, groups by age, hand radiography, human, lumbar spine, male, priority journal, school child, wrist, Absorptiometry, Photon, Age Determination by Skeleton, Age Factors, Colitis, Ulcerative, Humans, Lumbar Vertebrae, Reference Values, Sex Factors
DOI: 10.1097/MPG.0b013e31818cb4b6
ISSN: 0277-2116
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Exercise & Nutrition Sciences
Deposited On: 20 Oct 2015 01:13
Last Modified: 27 Oct 2015 02:08

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