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009) than those with BMD z-score -2. In total, 59% of children with BMI z-score -0.5 had moderate-severe osteopenia and only 18% of those with higher z-scores. Multivariate logistic regression identified BMI z-score as the sole risk factor (OR 1.28 [95% CI 1.08-1.52], P = 0.005). BMI z-score ≥-0.5 excludes osteopenia with a sensitivity 87%, specificity 49%, NPV 82%, and PPV 59%. Osteopenia was found in nearly half of children with newly onset CD. BMI z-score -0.5 should prompt referral to DXA screening. Osteopenia was found i
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