Longitudinal Study of Cortical Bone Loss in Patients with Inflammatory Bowel Disease

Clements, D.; Motley, Richard; Evans, W. D.; Harries, Anthony; Rhodes, J.; Coles, R. J.; Compston, JE

doi:10.3109/00365529209028138

Cited by 90 publications

(34 citation statements)

References 26 publications

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“…In accordance with the findings of others [1][2][3][4][5][6][7][8][9], osteocalcin levels in our patients with Crohn's disease differed from those of healthy controls. However, this only reflects a statistical mean value in all patients, including patients with different inflammatory activities and different levels of physiological exercise.…”

Section: Discussionsupporting

confidence: 79%

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Rapid spinal trabecular bone loss in female patients with ileitis terminalis Crohn and additional sacroiliac joint inflammation

Teichmann

Lange

Stracke

et al. 1997

Rheumatology International

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Patients with Crohn's disease are well known to have local and generalized osteopenia of varying degrees. The aim of this study was to investigate whether the additional involvement of the sacroiliac joint as an extraintestinal manifestation has an influence on bone turnover in female patients with Crohn's disease. Osteocalcin and other parameters of bone metabolism were measured in 79 female patients with Crohn's disease. Bone mineral density (BMD) was measured using dual energy X-ray absorptiometry (DEXA). Z scores were obtained by comparison with age- and sex-matched normal values. As regards the sacroiliac involvement (n = 26; group 1), we found a significantly lower BMD in the lumbar spine (L4) and in Ward's triangle of the femoral neck compared to controls (P < 0.05) and those patients (n = 53; group 2) with pure ileitis terminalis Crohn. Furthermore, the duration of the disease process in patients with Crohn's disease and extraintestinal involvement was markedly shorter than that of patients in group 2 (P < 0.05). In conclusion, osteoporosis in female patients with sacroiliac involvement manifested itself in a more severe way.

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Section: Discussionsupporting

confidence: 79%

“…Patients with Crohn's disease are well known to have local and generalized osteopenia of varying degrees [1][2][3][4][5][6][7][8][9]. However, the aetiology of this skeletal complication is still poorly understood.…”

Section: Introductionmentioning

confidence: 99%

Rapid spinal trabecular bone loss in female patients with ileitis terminalis Crohn and additional sacroiliac joint inflammation

Teichmann

Lange

Stracke

et al. 1997

Rheumatology International

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“…Estudos prévios, que utilizaram como referência um Z score menor que -2,0, mostraram prevalência bastante variável, entre 2% e 32%, mas com grande diferença entre os pacientes estudados, principalmente quanto a idade, grau de atividade e tempo de doença e uso de corticosteróides (34)(35)(36)(37)(38)(39). Pode-se considerar essa prevalência ainda mais preocupante se levar em conta o tempo de doença relativamente curto nos pacientes do presente estudo (6,30 4,60 na DC e 5,60 3,80 na RCUI) e ainda o fato destes pacientes serem adultos jovens.…”

Section: Souza Et Alunclassified

Níveis baixos de 25-hidroxivitamina D (25OHD) em pacientes com doença inflamatória intestinal e sua correlação com a densidade mineral óssea

Souza

Lora

Kulak

et al. 2008

Arq Bras Endocrinol Metab

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RESUMOIntrodução: Pacientes com doenças inflamatórias intestinais (DII) estão propensos a apresentar níveis baixos de vitamina D (25OHD) e densidade mineral óssea (DMO) diminuída. Objetivo: Verificar o nível de 25OHD em jovens com DII submetidos à avaliação clínica, dosagens bioquímicas rotineiras e medida da DMO de coluna lombar e fêmur, comparando-os com controles saudáveis. Resultados: 39 pacientes com doença de Crohn (DC) (p = 0, 003) e 37 com retocolite ulcerativa inespecífica (RCUI) (p < 0,001) apresentaram níveis mais baixos de 25OHD comparados aos controles, 48,5% dos pacientes com RCUI tinham deficiência de 25OHD. A DMO em coluna lombar foi mais baixa nos doentes (DC p = 0,001; RCUI p = 0,008). A 25OHD correlacionou-se significativamente com a DMO do fêmur total (r = 0,391; p = 0,027) e colo do fêmur (r = 0,384; p = 0,03) na DC. Conclusão: Foram encontrados níveis baixos de 25OHD e DMO em jovens com DII, sugerindo papel importante desta deficiência na patogênese da doença óssea desses pacientes. ABSTRACT Low Levels of 25-Hydroxyvitamin D (25OHD) in Patients with Inflammatory Bowel Disease and its Correlation With Bone Mineral Density.Patients with inflammatory bowel disease (IBD) are at risk of having vitamin D deficiency (25-OHD) and low bone mineral density (BMD). Objectives: To measure 25OHD in a young group of IBD patients submitted to a clinical evaluation, routine biochemistry and BMD measurement (lumbar spine and proximal femur). Results: 39 Crohn disease (CD) and 37 ulcerative colitis (UC) patients had lower serum levels of 25OHD compared to the control group (CD p = 0,003; UC p < 0,001), and 48.5% of the UC patients were 25OHD deficient. Lumbar spine BMD was lower in patients than controls (CD p = 0,001; UC p = 0,008). In CD patients, serum levels of 25OHD were significantly correlated with total femur (r = 0,391; p = 0,027) and femoral neck (r = 0,384; p = 0,03) BMD. Conclusion: It was found lower levels of 25OHD and BMD in young IBD patients compared to normal controls, suggesting an important role of 25OHD deficiency in the pathogenesis of the IBD bone disease.

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“…3,4 The osteoporosis seen in female patients with Crohn's disease can be prevented by sex hormone replacement therapy (HRT). 5,6 Jejunoileal bypass surgery has been performed for morbid obesity and, more recently, for hyperlipidaemia. By the 1980s it was estimated that, worldwide, many tens of thousands of operations had been performed.…”

Section: Introductionmentioning

confidence: 99%

Reduced bone mineral density after surgical treatment for obesity

et al. 1999

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OBJECTIVE: To investigate whether osteoporosis occurs after surgical treatment for obesity. DESIGN: A cross-sectional study of ®ve groups of subjects who had undergone surgical treatment for obesity: ®ve premenopausal women; 13 post-menopausal women; seven post-menopausal women taking oestrogen replacement (HRT); ®ve men; and six women who had undergone surgical reversal (mean time 7 y). SUBJECTS: Thirty-six Caucasian subjects who had undergone jejunoileal or pancreaticobiliary bypass surgery at St George's Hospital between 1971 and 1992. Their mean age was 50.8 y (range 32 ± 69 y) and the median time since the operation was 14.8 y (range 4 ± 23 y). MEASUREMENTS: A clinical questionnaire was used to exclude possible factors, which might in¯uence bone mineral density. A single blood sample was collected for measurement of calcium, phosphate, alkaline phosphatase, albumin, magnesium, zinc, creatinine, thyroxine, 25-hydroxy-vitamin D, sex steroids, gonadotrophins and IGF-1 and 24 h urine calcium excretion was measured. Bone mineral density (BMD) was measured in the lumbar (L2-L4) spine (LS) and femoral neck (FN) by dual energy X-ray absorptiometry (DEXA). RESULTS: There was no difference in serum calcium, alkaline phosphatase, IGF-1, 25-hydroxy-vitamin D (25-OH vitamin D), magnesium or zinc concentrations between the ®ve groups. The LS-BMD T score was lower (P`0.05) in male subjects ( 7 2.08 AE 1.04 mean 1.0 AE s.d) and post-menopausal women not taking HRT ( 7 1.21 AE 1.33) compared to the surgically reversed group (0.87 AE 2.36). The male group was most severely affected, despite normal serum testosterone concentrations. Two of the ®ve men studied, had a LS-BMD T score`7 2.5 and two had a LS-BMD T score between 7 1.0 and 7 2.5. In contrast, six of the seven post-menopausal women on HRT had an LS BMD T score b 7 1.0. There was no difference in the FN-BMD between the ®ve groups. The presence of low BMD was not related to age, duration of bypass, or degree of postoperative weight loss. Iliac crest bone biopsies in three subjects with low BMD, con®rmed the presence of osteoporosis. CONCLUSIONS: Reduced bone mineral density is a complication of jejunoileal bypass surgery.

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Longitudinal Study of Cortical Bone Loss in Patients with Inflammatory Bowel Disease

Cited by 90 publications

References 26 publications

Rapid spinal trabecular bone loss in female patients with ileitis terminalis Crohn and additional sacroiliac joint inflammation

Rapid spinal trabecular bone loss in female patients with ileitis terminalis Crohn and additional sacroiliac joint inflammation

Níveis baixos de 25-hidroxivitamina D (25OHD) em pacientes com doença inflamatória intestinal e sua correlação com a densidade mineral óssea

Reduced bone mineral density after surgical treatment for obesity

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