An Increased Serum N-Terminal Telopeptide of Type I Collagen, a Biochemical Marker of Increased Bone Resorption, Is Associated with Infliximab Therapy in Patients with Crohn’s Disease

Sugimoto, Ken; Ikeya, Kentaro; Iida, Takayuki; Kawasaki, Shinsuke; Arai, Osamu; Umehara, Keita; Watanabe, Fumio; Tani, Shinya; Oishi, Shinji; Osawa, Satoshi; Yamamoto, Takayuki; Hanai, Hiroyuki

doi:10.1007/s10620-015-3838-y

Cited by 13 publications

(17 citation statements)

References 39 publications

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“…Use of anti-TNF therapy, on the other hand, may increase bone density, whether by direct beneficial impact on bone physiology or by decreasing disadvantageous inflammatory changes on bone health, although still under debate [68][69][70][71]. Commonly used IBD medication, belonging to other therapeutic classes, such as mesalazines, immunosuppressants, and newly developed biologics or small molecules, like vedolizumab and tofacitinib, have not extensively been studied with regard to bone physiology.…”

Section: Ibd-related Therapymentioning

confidence: 99%

Perspective on skeletal health in inflammatory bowel disease

Bodegraven

Bravenboer

2019

Osteoporos Int

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Osteopenia and osteoporosis are common features in inflammatory bowel disease (IBD), comprising both Crohn's disease and ulcerative colitis. Moreover, Crohn's disease is associated with increased fracture risk. The etiology of bone loss in IBD is multifactorial. It includes insufficient intake or absorption of calcium, vitamin D, and potassium; smoking; a low peak bone mass; a low body mass index; and decreased physical activity. In several studies, it has been shown that elevated concentrations of systemic and local pro-inflammatory cytokines, including tumor necrosis factor alpha (TNF-α), interferon-γ (IFNγ), interleukin (IL)-1β, IL-4, IL-5, IL-6, IL-13, and IL-17, present in IBD patients are potentially detrimental for bone metabolism and may be responsible for bone loss and increased fracture risk. This perspective aims to review the current literature on the role of inflammatory factors in the pathophysiology of skeletal problems in IBD and to suggest potential treatment to improve bone health, based on a combination of evidence and clinical and pathophysiological reasoning.

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Section: Ibd-related Therapymentioning

confidence: 99%

Perspective on skeletal health in inflammatory bowel disease

Bodegraven

Bravenboer

2019

Osteoporos Int

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“…Because bone metabolism markers are easily affected by the diet, serum samples for biochemical measurements were collected under fasting conditions [26]. This method has been described previously [23]. Brie y, the blood samples were centrifuged at 3,000 rpm for 10 min at 4 °C.…”

Section: Biochemical Measurementsmentioning

confidence: 99%

“…The serum levels of bone metabolism markers, namely ucOC, 1,25-(OH) 2 D, NTx, and BAP, were estimated by an electrochemiluminescence immunoassay (Sanko, Tokyo, Japan), radioimmunoassay (Immunodiagnostic Systems, Boldon, UK), enzyme-linked immunosorbent assay (Ostex, Seattle, WA, USA), and enzyme immunoassay (Quidel, San Diego, CA, USA), respectively. All laboratory measurements were blinded to the investigators and were performed at a special research laboratory [23].…”

Section: Biochemical Measurementsmentioning

confidence: 99%

“…This method has been described previously [23]. Brie y, the BMD of the L2-L4 lumbar vertebrae was measured initially and 2 years later using the Discovery DXA System (Discovery A; Hologic, Bedford, MA, USA) and expressed using absolute values (g/cm 2 ) and Z-scores [28].…”

Section: Measurement Of Bmd and Determination Of The Z-scoresmentioning

confidence: 99%

“…In a previous cross-sectional study [23], we examined the association between biochemical bone metabolism markers (namely BAP, NTx, ucOC, and 1,25-dihydroxyvitamin D [1, 2 D]) and bone density in IBD patients and reported that the serum NTx level, a biochemical marker predicting an increase in bone resorption, is signi cantly elevated in patients with CD receiving in iximab (IFX). However, in this study, the BMD and bone metabolism markers were examined in a single measurement, and we realized the need to investigate long-term changes in bone metabolism over time.…”

Section: Introductionmentioning

confidence: 99%

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Serum N-Terminal Telopeptide of Type I Collagen as a Biomarker for Predicting Bone Density Loss in Patients with Crohn Disease

Ishida

Higuchi

Miyazu

et al. 2020

Preprint

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Background: The serum N-terminal telopeptide of type I collagen (NTx) is significantly higher in patients with Crohn disease (CD) than in healthy individuals and patients with ulcerative colitis. This study aimed to investigate whether an elevated serum NTx level is a risk predictor of osteoporosis in patients with CD.Methods: Based on whether the femoral Z-score decreased over a 2-year period, 41 CD patients were divided into the ΔZ-score <0 group (Z-score decreased) and the ΔZ-score ≥0 group (Z-score did not decrease). The risk predictors of a femoral Z-score decrease were examined. Furthermore, we investigated the correlations between the ΔZ-score (which represents the change in the Z-score over a 2-year period) and the mean levels of biomarkers including the Crohn’s Disease Activity Index (CDAI), serum albumin, C-reactive protein, and bone metabolism markers (including NTx) measured initially (i.e., in our previous study) and 2 years later (present study). The relation between anti-tumor necrosis factor α (anti-TNF-α) therapy and serum NTx levels were also examined.Results: Although there was no correlation between the mean CDAI and the ΔZ-score, the mean serum NTx and albumin levels were significantly correlated with the ΔZ-score (P<0.01 and P=0.02, respectively). Furthermore, the femoral Z-score tended to be lower in the anti-TNF-α administration group than in the non-administration group.Conclusions: These observations indicated that an elevated serum NTx could be a useful marker for predicting a decrease in the femoral bone mineral density in CD patients. Anti-TNF-α therapy maintained an elevated serum NTx level, suggesting that treatment with anti-TNF-α may help control increased bone resorption in CD patients.

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Risk of fracture and low bone mineral density in adults with inflammatory bowel diseases. A systematic literature review with meta-analysis

et al. 2018

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Inflammatory bowel diseases (IBDs) are associated with a decreased bone mineral density, but the impact on fractures is unknown. In our study, global risk of fracture is increased for patients with IBDs versus controls. This result will help to determine the appropriate assessment with early screening and management of osteoporosis. Inflammatory bowel diseases (IBDs), such as Crohn's disease (CD) and ulcerative colitis (UC), are associated with a decreased bone mineral density (BMD). However, the impact on fracture risk is unknown and data are contradictory across studies. In this systematic review and meta-analysis, we aimed to assess the risk of fracture and presence of low BMD in patients with IBDs compared to healthy controls. A systematic search of literature was conducted of MEDLINE, EMBASE, the Cochrane library and abstracts from appropriate scientific congresses. Studies were selected if they compared the incidence of fractures and/or BMD measurement by dual-energy X-ray absorptiometry in patients with IBDs and healthy sex- and age-matched controls. Data were extracted by two independent investigators. Meta-analysis was performed with the inverse variance approach to estimate pooled odds ratios (ORs) and risk ratios (RRs) with their 95% confidence intervals (CIs). Twenty-four studies met the inclusion criteria. On the basis of nine studies, global risk of fracture was increased for patients with IBDs versus controls (RR = 1.38, 95% CI 1.11-1.73; p = 0.005). Fracture risk with IBDs was significantly increased for vertebral fractures (OR = 2.26, 95% CI 1.04-4.90; p < 0.001), but not for any other site. The analysis of 16 studies evaluating BMD showed a significant decrease in mean BMD and Z-scores for IBD patients versus controls at all sites. In our meta-analysis, patients with IBDs have an increased risk of fractures, especially in the spine, and significant decreased BMD at all sites, which suggests the need for identifying high-risk individuals among this population.

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An Increased Serum N-Terminal Telopeptide of Type I Collagen, a Biochemical Marker of Increased Bone Resorption, Is Associated with Infliximab Therapy in Patients with Crohn’s Disease

Abstract: A lower BMD and higher bone metabolism markers were found in CD patients as compared to controls or UC patients. A significant increased serum level of NTx, a biochemical marker of increased bone resorption, was observed in CD patients during IFX therapy.

Cited by 13 publications

References 39 publications

Perspective on skeletal health in inflammatory bowel disease

Perspective on skeletal health in inflammatory bowel disease

Serum N-Terminal Telopeptide of Type I Collagen as a Biomarker for Predicting Bone Density Loss in Patients with Crohn Disease

Risk of fracture and low bone mineral density in adults with inflammatory bowel diseases. A systematic literature review with meta-analysis

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