Skeletal Health and Bone Marrow Composition in Newly Diagnosed Adolescent Girls With Crohn Disease

Summary

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Less than optimal bone health has been seen in children that have inflammatory bowel disease (IBD), including Crohn disease (CD). This can present as low bone density or altered bone structure, weakening the bones and increasing fragility and fracture risk. As adolescence is especially important in ...

Less than optimal bone health has been seen in children that have inflammatory bowel disease (IBD), including Crohn disease (CD). This can present as low bone density or altered bone structure, weakening the bones and increasing fragility and fracture risk. As adolescence is especially important in bone development, conditions such as CD during this time can lead to long term bone issues. The underlying mechanisms are not well understood, but what is known is that red bone marrow converts to fat-rich yellow marrow. This pilot study aims to focus on abnormalities in bone marrow, and specifically whether adolescent girls who have been diagnosed with CD have more bone marrow fat. The primary hypothesis is that newly diagnosed CD is associated with increased fat levels in bone, which is associated with lesser bone formation and worse bone health. The central objective is to obtain pilot data on the differences in bone marrow between healthy adolescent girls and those with CD. Long term, the investigators want to study how abnormal fat tissue and sub-optimal bone health relate to each other. The study involves 10 adolescent females recently diagnosed with CD and 10 healthy females. Eligibility criteria include no other chronic diseases that affect bone health and limited use of bone altering medications in the last three months. The CD females will be matched with healthy females based on age, stage of puberty, height percentile, and BMI percentile. Additional data on CD participants will be collected via a chart review that will enable us to more fully characterize their CD. Imaging will include MRIs of the knee. Measurements will include a visual assessment and quantitative marrow fat analysis, dual-energy X-ray absorptiometry (DXA), and peripheral quantitative computed tomography (pQCT). All scans will be for research purposes only. The MRIs will be evaluated for any abnormalities, and if there is an incidental finding, it will be reported to the primary care physician.

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