Crohn’s disease (CD) chronic inflammation is linked to decreased bone mineral density (BMD). Since bone mass is nearly entirely acquired throughout childhood, early detection of osteopenia is extremely crucial in paediatric CD. Researchers wanted to find out what factors are linked to osteopenia so that we might direct dual-energy X-ray absorptiometry (DXA) scan screening to people who need it the most. This was a retrospective cohort study of children newly diagnosed with CD who were frequently sent to DXA scans. Demographic and explicit clinical data were collected, as well as whole-body less head BMD adjusted for age, gender, and height using z-scores. Of the 116 boys included in the study, 63 had normal BMD or borderline osteopenia, whereas 53 had osteopenia. Osteopenia was related with a lower BMI z-score and a greater PCDAI than individuals with a BMD z-score >2. In all, 59 percent of children with a BMI z-score of 0.5 had moderate-severe osteopenia, compared to just 18 percent of those with higher z-scores. BMI z-score was found as the single risk factor using multivariate logistic regression. BMI z-score 0.5 eliminates osteopenia with a sensitivity of 87 percent, specificity of 49 percent, NPV of 82 percent, and PPV of 59 percent.

Osteopenia was detected in nearly half of the children with newly diagnosed CD. A BMI z-score of 0.5 should trigger referral for DXA screening.

Reference: https://journals.lww.com/jpgn/Abstract/2021/02000/Clinical_Criteria_Can_Identify_Children_With.19.aspx

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