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dc.contributor.authorTsampalieros, Anne
dc.contributor.authorLam, Carol K. L.
dc.contributor.authorSpencer, Jenna C.
dc.contributor.authorThayu, Meena
dc.contributor.authorShults, Justine
dc.contributor.authorZemel, Babette S.
dc.contributor.authorHerskovitz, Rita M.
dc.contributor.authorBaldassano, Robert N.
dc.contributor.authorLeonard, Mary B.
dc.date.accessioned2014-01-09T20:25:34Z
dc.date.available2014-08-10T09:30:25Z
dc.date.issued2013-08
dc.identifier.bibliographicCitationTsampalieros, A., Lam, C. K. L., Spencer, J. C., Thayu, M., Shults, J., Zemel, B. S., Herskovitz, R. M., Baldassano, R. N. and Leonard, M. B. Long-Term Inflammation and Glucocorticoid Therapy Impair Skeletal Modeling During Growth in Childhood Crohn Disease. Journal of Clinical Endocrinology & Metabolism. 2013. 98(8): 3438-3445. DOI: 10.1210/jc.2013-1631en_US
dc.identifier.issn0021-972X
dc.identifier.urihttp://hdl.handle.net/10027/11048
dc.descriptionThis is a copy of an article published in the Journal of Clinical Endocrinology and Metabolism © 2013 Endocrine Society.en_US
dc.description.abstractContext: Glucocorticoids and inflammation inhibit bone formation; however, the impact on skeletal modeling is unknown. Objectives: The objectives of the study were to examine changes inbonemineral density(BMD) and cortical structure after Crohn disease (CD) diagnosis and identify associations with growth, glucocorticoids, and disease activity. Design/Participants: This was a prospective cohort study among 76 CD participants, aged 5-21 years. Tibia quantitative computed tomography trabecular BMD and cortical dimensions were obtained at diagnosis and 6 and 12 and a median of 42 months later; 51 completed the final visit. Outcomes: Sex, race, and age-specific Z-scores were generated for outcomes based on more than 650 reference participants, and cortical dimension Z-scores were further adjusted for tibia length. Generalized estimating equations were used to model changes in Z-scores. Results: Disease activity improved over the study interval (P <.001). TrabecularBMDZ-scoresimproved over the first 6 months; increases were associated with improved disease activity (P <.001), younger age (P <.005), and increases in vitamin D levels (P = .02). Greater increases in tibia length were associated with greater increases in cortical area Z-scores (P <.001). Greater glucocorticoid doses and disease activity were significantly associated with failure to accrue cortical area and were more pronounced with greater linear growth (interaction P <.05). Mean (+/- SD) trabecular BMD (similar to 1.0 +/- 1.21) and cortical area (similar to 0.57 +/- 1.10) Z-scores at the final visit were significantly reduced. Conclusions: CD was associated with persistent deficits in trabecular BMD, although younger participantsdemonstratedagreater potential for recovery. In addition, greater lineargrowthwasassociated with a greater recovery of cortical dimensions, especially among participants with less glucocorticoid exposure and inflammation. These data suggest that younger age and concurrent growth provide a window of opportunity for skeletal recovery.en_US
dc.language.isoen_USen_US
dc.publisherEndocrine Societyen_US
dc.subjectglucocorticoiden_US
dc.subjectbone diseaseen_US
dc.subjectbone growthen_US
dc.subjectCrohn's Diseaseen_US
dc.titleLong-Term Inflammation and Glucocorticoid Therapy Impair Skeletal Modeling During Growth in Childhood Crohn Diseaseen_US
dc.typeArticleen_US


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