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Background: IBD, with its associated cytokines and corticosteroid treatment, is implicated in reducing bone mineral density (BMD) at the time of maximal bone accrual in the growing skeleton. Objective: To comprehensively assess the bone health of children with IBD and corticosteroid exposure. Methods: Children with IBD and two months minimum corticosteroid treatment were recruited. Assessment included height, weight, pubertal status, cumulative steroid exposure, serum calcium, phosphate, alkaline phosphatase, parathyroid hormone and vitamin D levels. Areal (aBMD) and volumetric (BMAD) bone densitometry were performed. Bone morphology was assessed using magnetic resonance imaging (MRI). Results: 41 IBD patients were recruited (mean 14yrs [5 18]) with a mean disease duration of 27 months. 12% had aBMD lumbar spine (LS) Z-score 2 (mean 1.3 [95%CI: 1.6, 1]). BMAD showed less reduction with 7% of subjects having a LS Z score 2 (mean 0.63 [95%CI: 0.66, 0.6]). The prevalence of vitamin D insufficiency (50nmol/L) was 19% and 7% had reduced vertebral height on MRI. Correlation between cumulative steroid dose and BMAD did not reach statistical significance. Conclusion: Low aBMD reflects reduced bone accrual and linear growth rate. The reduction is less marked using BMAD suggesting aBMD overstates reductions in BMD. Though morphological changes were minimal and infrequent, a longitudinal study of fracture risk in pediatric IBD is needed.

P071 DXA'S AIN'T DXA'S TAKING A CLOSER LOOK AT BONE HEALTH IN PEDIATRIC INFLAMMATORY BOWEL DISEASE (IBD)