Several colleagues with birthdays this week and next–Happy Birthday!
At our ICN population management meeting (as well as at a recent nutrition colloquium), Dr. Karen Loechner provided a timely update on bone health for our group. Some of her slides are pictured below and a link to full slides follows.
Some of the points that I found interesting:
- New hologic scans are much quicker (as little as 15 secs for some images) than typical DXA scans
- While sodas have been associated with weaker bones, the main mechanism is likely displacement of milk from diet rather than direct effects
- Adjust DXA results for height age
- Think about vertebral compression fractures in children with mobility problems and painful symptoms
Full Link: Sticks and Stones Pediatric Osteoporosis
It is well-recognized that Crohn’s disease is associated with delays in the onset and progression of puberty with the potential for stunted growth, impaired bone accrual, and diminished quality of life.
Now, a study (MD DeBoer et al. J Pediatr 2016; 171: 146-52) shows that initiation of anti-tumor necrosis factor α (anti-TNFα) treatment results in a rapid increase in sex hormone and gonadotropin levels.
In 72 adolescents, this observational study followed levels of sex hormones, gonadotropin levels, dual-energy x-ray absorptiometry, along with cytokine/inflammatory markers at initiation of anti-TNFα therapy, at 10 weeks and at 12 months.
- By week 10 , testosterone z scores in males increased from a median of -0.36 to 0.40 (P<0.05)
- By week 10 , estradiol z scores in females increased from a median of -0.35 to -0.02 (P<0.01)
My take (from the authors): This study suggests that “systemic inflammation suppresses gonadotropin-stimulated production of sex hormones” and that treatment of this inflammation with anti-TNFα agents allows rapid resumption normal production.
Related blog posts:
Law Quad, Univeristy of Michigan