Pathogenesis of Musculoskeletal Deficits in Children and Adults with Inflammatory Bowel Disease

Nutrients. 2021 Aug 23;13(8):2899. doi: 10.3390/nu13082899.

Abstract

Musculoskeletal deficits are among the most commonly reported extra-intestinal manifestations and complications of inflammatory bowel disease (IBD), especially in those with Crohn's disease. The adverse effects of IBD on bone and muscle are multifactorial, including the direct effects of underlying inflammatory disease processes, nutritional deficits, and therapeutic effects. These factors also indirectly impact bone and muscle by interfering with regulatory pathways. Resultantly, individuals with IBD are at increased risk of osteoporosis and sarcopenia and associated musculoskeletal morbidity. In paediatric IBD, these factors may contribute to suboptimal bone and muscle accrual. This review evaluates the main pathogenic factors associated with musculoskeletal deficits in children and adults with IBD and summarises the current literature and understanding of the musculoskeletal phenotype in these patients.

Keywords: Crohn’s disease; bone; inflammation; inflammatory bowel disease; muscle; osteoporosis.

Publication types

  • Review

MeSH terms

  • Age Factors
  • Body Composition
  • Bone Remodeling
  • Colitis, Ulcerative / blood
  • Colitis, Ulcerative / complications*
  • Colitis, Ulcerative / physiopathology
  • Crohn Disease / blood
  • Crohn Disease / complications*
  • Crohn Disease / drug therapy
  • Crohn Disease / physiopathology
  • Cytokines / blood
  • Glucocorticoids / adverse effects
  • Humans
  • Inflammation Mediators / blood
  • Musculoskeletal Diseases / blood
  • Musculoskeletal Diseases / etiology*
  • Musculoskeletal Diseases / physiopathology
  • Nutritional Status
  • Osteoporosis / blood
  • Osteoporosis / etiology
  • Osteoporosis / physiopathology
  • Risk Assessment
  • Risk Factors
  • Sarcopenia / blood
  • Sarcopenia / etiology*
  • Sarcopenia / physiopathology

Substances

  • Cytokines
  • Glucocorticoids
  • Inflammation Mediators

Supplementary concepts

  • Pediatric Crohn's disease
  • Pediatric ulcerative colitis