Trabecular Bone Score in Children and Adolescents With Inflammatory Bowel Diseases
Trabecular Bone Score in Children and Adolescents With Inflammatory Bowel Diseases
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DOI：
10.1016/j.jocd.2020.10.008
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发表时间：
2020-04-01
影响因子：
2.5
通讯作者：
Weiss, Batia
中科院分区：
文献类型：
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作者：
Levy-Shraga, Yael;Megnazi, Ophir;Weiss, Batia
简介：骨小梁评分（TBS）是评估腰椎骨微结构的纹理指标。我们的目的是评估炎症性肠病儿童的 TBS 并评估其与临床、实验室和密度变量的相关性。方法：对患有克罗恩病 (CD) 或溃疡性结肠炎 (UC) 的儿童进行 TBS 和双能 X 射线骨密度测定 (DXA) 测量的回顾性研究。计算骨矿物质表观密度以调整尺寸。每个孩子的 TBS Z 分数是根据年龄和性别分布相似的健康人群的数据计算的。与 TBS 显着相关的变量包含在逐步线性回归模型中，以检查 TBS 的独立预测因素。结果：纳入 50 名患者（DXA 扫描年龄 13.8 ± 3.0 岁，29 名男性）。 CD 和 UC 患者在诊断年龄、DXA 扫描年龄和病程方面没有观察到显着差异。 CD 患者 (n = 35) 的平均 TBS 低于 UC 患者 (n = 15)：1.340 ? 0.080 与 1.395 ？ 0.092，p = 0.040。 CD 患者的平均 TBS Z 评分为 -0.443 ？ 0.788，显着低于健康儿童的预期 (p = 0.002)，而 UC 患者的平均 TBS Zscore 为 0.231 ? 0.685，与健康儿童相似（p = 0.212）。在逐步线性回归分析中，诊断时的 BMI Z 分数、诊断时的磷水平和 DXA 扫描时的年龄是 TBS 的显着独立预测因子（r2 = 0.604；0 = 0.037，95% 置信区间 (CI) 为 0 0.022-0.051，p < 0.001；0= 0.045，95% CI： 0.017-0.073，p = 0.002；0= 0.031，95% CI：0.005-0.021，p < 0.002。结论：患有 CD 的儿科患者的 TBS 显着降低，但 UC 患者的 TBS 却没有显着降低。这一发现可能反映了 CD 对骨微结构的影响。
Introduction: Trabecular bone score (TBS) is a textural index that evaluates bone microarchitecture of the lumbar spine. Our aim was to assess TBS in children with inflammatory bowel diseases and to evaluate correlations with clinical, laboratory and densitometric variables. Methods: A retrospective study of TBS and areal bone mineral density measurements by dual-energy X-ray absorptiometry (DXA) of children with either Crohn?s disease (CD) or ulcerative colitis (UC). Bone mineral apparent density was calculated for size adjustment. TBS Z-score for each child were calculated based on data from a healthy population of similar age and gender distribution. Variables significantly associated with TBS were included in stepwise linear regression models to examine independent predictors of TBS. Results: Fifty patients (age at DXA scan 13.8 ? 3.0 years, 29 males) were included. No significant differences were observed between the patients with CD and UC, in age at diagnosis, age at DXA scan and disease duration. The mean TBS of patients with CD (n = 35) was lower than of patients with UC (n =15): 1.340 ? 0.080 vs 1.395 ? 0.092, p = 0.040. The mean TBS Z-score of patients with CD, -0.443 ? 0.788, was significantly lower than expected in healthy children (p = 0.002), while the mean TBS Zscore of patients with UC, 0.231 ? 0.685, was similar to that of healthy children (p = 0.212). In the stepwise linear regression analysis, BMI Z-score at diagnosis, phosphorus level at diagnosis and age at the time of the DXA scan were significant independent predictors of TBS (r2 = 0.604; 0 = 0.037, 95% confidence interval (CI) for 0 0.022-0.051, p < 0.001; 0= 0.045, 95% CI: 0.017-0.073, p = 0.002; and 0= 0.031, 95% CI: 0.005-0.021, p < 0.002, respectively). Conclusions: TBS is significantly reduced in pediatric patients with CD but not in patients with UC. This finding likely reflects the effect of CD on bone microarchitecture.