A recent study conducted by researchers at the Children’s Hospital of Philadelphia (CHOP) has revealed a potential hidden risk for children and young adults suffering from inflammatory bowel disease (IBD). The research indicates that many young patients with IBD may have low bone mineral density (BMD), increasing their chances of fractures and long-term bone issues. These findings were published in the Journal of Pediatric Gastroenterology and Nutrition.
Inflammatory bowel disease, which encompasses Crohn’s disease and ulcerative colitis, is typically diagnosed through gastrointestinal symptoms. However, it can also impact nutrient absorption, crucial for maintaining strong bones.
“Our findings confirm that children and teens with IBD are vulnerable to developing low bone mineral density, and that low BMI Z-score can help identify patients most at risk,” stated Kanak Kennedy, previously a pediatric gastroenterology fellow at CHOP. “These results highlight the need for more routine screening and intervention to prevent long-term complications.”
The study was a single-center retrospective analysis involving 600 patients aged 3 to 22 years who underwent dual-energy x-ray absorptiometry (DXA) scans between 2006 and 2019. DXA scans are recognized as the gold standard for assessing bone density. Researchers collected demographic, clinical, and lab data to identify predictors of low BMD, defined by Z-scores. A subset of 378 patients also had genetic data available, allowing for an assessment of genetic risk factors using polygenic risk scores derived from genome-wide association studies.
The research team identified several factors potentially increasing the risk of low BMD in young patients: prolonged disease activity, steroid use, delayed growth or puberty, and deficiencies in calcium or vitamin D. The authors emphasized that lower BMI should prompt DXA monitoring in pediatric IBD patients and noted that genetic predisposition might be useful in identifying those at higher risk.
This study received funding from the Tobacco Formula grant under the Commonwealth Universal Research Enhancement (C.U.R.E) program (SAP #4100068710).
Kennedy et al.’s work titled “Prevalence and predictors of low bone mineral density in pediatric inflammatory bowel disease” appeared online on April 29, 2025. DOI:10.1002/jpn3.7004.
