Altered levels of biochemical indices of bone turnover and bone‐related vitamins in patients with Crohn's disease and ulcerative colitis

Abstract

SUMMARY BackgroundThe pathogenesis of inflammatory bowel disease-associated osteopenia may be related to pathological rates of bone turnover; however, the literature shows mixed results.

Altered bone metabolism in inflammatory disease: role for nutrition

“…Furthermore, serum undercarboxylated osteocalcin was found to be independently correlated with markers of bone resorption and bone formation, and thus the rate of bone turnover, in the group of patients with IBD (CD and UC), as well as in the patients with UC (40) . The reasons for the lower vitamin K status in patients with IBD, especially in patients with UC, are unclear.…”

“…Studies of bone marker levels in patients with IBD have produced conflicting results. While some studies of have reported increased levels of bone resorptive markers without a compensatory increase in formation markers (31)(32)(33)(34)(35) , other studies have reported reduced levels of markers of bone formation and no difference in resorptive markers (36) , elevated levels of both types of markers (37)(38)(39)(40) or indeed no difference in markers (41) between patients with IBD and control subjects. However, in addition to differences in the biochemical markers used, some caution is also warranted in comparing the results of some of these studies because of major differences in the various populations of patients with IBD that were studied, especially in relation to the type of disease (CD v. UC), corticosteroid usage and disease activity (active disease v. disease remission) (42) .…”

“…However, in addition to differences in the biochemical markers used, some caution is also warranted in comparing the results of some of these studies because of major differences in the various populations of patients with IBD that were studied, especially in relation to the type of disease (CD v. UC), corticosteroid usage and disease activity (active disease v. disease remission) (42) . For example, only three studies have compared the levels of bone turnover markers in patients with UC alone compared with controls (37,38,40) , and these have produced conflicting results. Similarly, only three studies have compared the levels of bone turnover markers in patients with quiescent CD, and not taking steroids, with those of controls (36,39,42) , and these studies also have produced conflicting results.…”

“…Ca deficiency (as a result of either low intake or poor intestinal efficiency of absorption) has been reported in CD (4,44,45) . Lower vitamin D status has been reported in patients with UC and CD compared with either control subjects or a healthy population reference range (24,40,(46)(47)(48)(49)(50)(51)(52) . Lower vitamin D status has recently been reported in patients with CD compared with age-and gender-matched controls during winter but also during summer (see Fig.…”

“…Diet and bone healthsubjects (40) . Furthermore, serum undercarboxylated osteocalcin was found to be independently correlated with markers of bone resorption and bone formation, and thus the rate of bone turnover, in the group of patients with IBD (CD and UC), as well as in the patients with UC (40) .…”