The Effect of Nutritional Therapy on Bone Mineral Density and Bone Metabolism in Pediatric Crohn Disease.
J Pediatr Gastroenterol Nutr
; 72(6): 877-882, 2021 06 01.
Article
em En
| MEDLINE
| ID: mdl-33587407
ABSTRACT
OBJECTIVES:
Both the inflammatory burden of Crohn disease (CD) and corticosteroids have a negative effect on bone density. Exclusive enteral nutrition (EEN) avoids corticosteroids and promotes endoscopic healing. We aimed to explore the effect of nutritional therapy on bone health in pediatric CD.METHODS:
This was a planned sub-study of a clinical trial enrolling children with new-onset mild-moderate CD. Children were randomized to either 6âweeks EEN followed by 6âweeks 25% partial enteral nutrition (PEN) or 6âweeks of 50% PEN with a CD exclusion diet followed by 6âweeks of 25% PEN with exclusion diet. Bone formation and resorption were measured at baseline, week 12 and week 24 by serum C-Propeptide of Type I Procollagen (CICP) and type I Collagen N-Telopeptide (NTX), respectively. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DXA) scan at baseline and week 24.RESULTS:
Median CICP improved from 130âng/mL (106-189) at baseline to 223 (143-258) at week 12 and 193 (143-252) at week 24 (Pâ=â0.016 for both, nâ=â29 children). Median NTX remained unchanged (Pâ=â0.45 and Pâ=â0.45). Thirty-six children had DXA scans performed at diagnosis; 81% and 33% had z scores of <-1 and <-2, respectively. DXA z scores did not improve from baseline (adjusted total body less head [TBLH] BMD -1.62â±â0.87) to week 24 (-1.76â±â0.75; Pâ=â0.30, nâ=â21 with both scans).CONCLUSIONS:
Low bone density is common in new-onset mild-moderate pediatric CD. CICP, a sensitive marker of bone formation, improved following dietary intervention but this was not associated with improved BMD.
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Base de dados:
MEDLINE
Métodos Terapêuticos e Terapias MTCI:
Terapias_biologicas
/
Trofoterapia
Assunto principal:
Doença de Crohn
/
Densidade Óssea
Tipo de estudo:
Clinical_trials
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Ano de publicação:
2021
Tipo de documento:
Article