Young Adult Male Patients With Childhood-onset IBD Have Increased Risks of Compromised Cortical and Trabecular Bone Microstructures

BACKGROUND: Young adults with childhood-onset inflammatory bowel disease (IBD) have increased risks of low areal bone mineral density and low skeletal muscle mass. Volumetric BMD (vBMD), bone geometry and microstructures, in addition to possible associations with skeletal muscle index (SMI) and physical exercise have been scarcely studied in this patient group. PATIENTS AND METHODS: In total, 49 young adult male patients with childhood-onset IBD and 245 age- and height-matched young adult male controls were scanned with high-resolution peripheral quantitative computed tomography. Bone geometry, vBMD, and bone microstructures were calculated as median values and compared between the patients and controls. Multivariable linear regression analyses were performed to determine the independent associations among IBD diagnosis, SMI (kg/m(2)), and physical exercise. RESULTS: The group of young adult patients had, in comparison with the controls, significantly smaller median cortical area (126.1 mm(2) vs151.1 mm(2), P < .001), lower median total vBMD (296.7 mg/cm(3) vs 336.7 mg/cm(3), P < .001), and lower median cortical vBMD (854.4 mg/cm(3) vs 878.5 mg/cm(3), P < .001). Furthermore, the patients compared with the controls had lower median trabecular volume fraction (16.8% vs 18.2%, P < .001) and thinner median trabeculae (0.084 mm vs 0.089 mm, P < .001). The differences between the patients with IBD and controls persisted in multivariable analyses that included adjustments for SMI and physical exercise. CONCLUSIONS: Young adult men with childhood-onset IBD are at increased risk of having reduced bone quality in both the cortical and trabecular bone structures compared with normative matched controls.