Reduced bone mineral density (BMD) has been reported in adults with Crohn's
disease (CD). Less is known about abnormal BMD in children and young adult
s with CD. The aims of this study are to determine the prevalence of low BM
D and to evaluate the effect of growth and pubertal development on BMD in c
hildren and young adults with CD. One hundred-nineteen patients with CD und
erwent dual-energy Xray absorptiometry (DXA) to determine BMD. Anthropometr
y and pubertal development were measured. Bone age was measured only in pat
ients older than 8 years of age and who had not grown in height during the
last year. One hundred-nineteen patients (72 male, 47 female) were evaluate
d. Seventy percent of patients had BMD z-scores less than or equal to -1.0
and 32% had z-scores less than or equal to -2.0. Weight and height z-scores
were significantly associated with BMD z-scores. BMD z-scores based on bon
e age and on chronological age were highly correlated, except when the chro
nological age BMD z-score was less than or equal to -2.0. BMD z-score was s
ignificantly different between males and females for the group (-1.75 +/- 1
.06 vs. -1.08 +/- 1.00), respectively. Children and young adults with CD ha
ve a high prevalence of low BMD and routine evaluation by DXA is indicated.
In patients with a chronological age-based BMD z-score I -2.0, a bone age-
based BMD should be considered.