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P135 Altered body composition profiles in young adults with childhood-onset inflammatory bowel disease

G. V. Sigurdsson*1,2, S. Schmidt3, D. Mellström4, M. Karlsson5, M. Lorentzon6,7, R. Saalman1,2

1Queen Silvia′s Children Hospital, Gothenburg, Sweden, 2Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Department of pediatrics, Gothenburg, Sweden, 3Premier Research LLC, Durham/NC, USA, 4Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Gothenburg, Sweden, 5Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics, University of Lund, Malmö, Sweden, 6Institute of Medicine, The Sahlgrenska Academy at University of Gothenburg, Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Gothenburg, Sweden, 7Sahlgrenska University Hospital, Geriatric Medicine, Gothenburg, Sweden

Background

Patients with inflammatory bowel disease (IBD) have an increased risk to develop lean mass and bone mass deficits. However, there are scarce data about the outcome in young adult patients with childhood-onset IBD. The aim of this study was to investigate body composition profiles with focus on skeletal muscle index (SMI) and fat percentage (fat %) and bone mineral density (BMD) in young adults with childhood-onset IBD. A second aim was to evaluate whether eventual body composition disturbances in young adulthood could be predicted from measurements in childhood.

Methods

A total of 94 out of 144 included patients in this prospective longitudinal study with median follow-up time of 8.4 years, had when these measurements were done reached adulthood (age ≥18 years). Body composition profiles in young adulthood were defined from dual X-ray absorptiometry estimated SMI and fat %. Normative age- and gender-matched data from the same region (N = 2480, age 6–30 years) were used to calculate individual Z-scores. Study participants were then classified based on a model proposed by Baumgartner (Ann N Y Acad Sci, 2000) as being (i) normal, (ii) obese (fat % Z-score >1SD), (iii) myopenic (SMI Z-score <−1 SD), or (iv) myopenic-obese. Risk of myopenia in adulthood was estimated with a logistic regression, based on a previous childhood SMI measurements available for 77 out of 94 patients.

Results

A higher proportion of young adults with childhood-onset IBD had a myopenic (24% vs. 15%, p = 0.016) or myopenic–obese (9% vs. 2%, p = 0.002) profile than age- and gender-matched healthy references (Figure 1).

Body composition profiles in young adulthood in 94 patients with childhood-onset IBD compared with reference data (M = 1181, F = 108). The proportional differences within each profile between patients and references were tested with Fisher’s exact test.

In patients with childhood-onset IBD, SMI Z-score correlated to whole body BMD Z-score (R = 0.61, p < 0.001). Patients with childhood-onset IBD had in young adulthood 0.3 SD (95% CI [0.15–0.51], p < 0.001) lower whole body BMD Z-score, than healthy age- and gender-matched controls after adjusting for SMI Z-score in a linear regression model. A SMI Z-score of 0 SD, −0.5 SD or −1 SD in children with IBD could predict the risk for myopenia to occur in young adulthood corresponding to 6%, 25%, and 64%, respectively.

Conclusion

A larger proportion of young adults with childhood-onset IBD had a myopenic or myopenic-obese body composition profile and lower BMD then healthy references. SMI measures in children with IBD could predict the risk for myopenia in young adulthood.