Assessment of bone metabolism in patients with inflammatory bowel disease
10.3760/cma.j.issn.0254-1432.2009.07.002
- VernacularTitle:炎症性肠病患者骨代谢状况评估
- Author:
Wenyan ZHANG
;
Yaozong YUAN
- Publication Type:Journal Article
- Keywords:
Crohn disease;
Colitis,ulcerative;
Osteoporosis
- From:
Chinese Journal of Digestion
2009;29(7):437-441
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the characteristics of biochcmical parameters of bone metabolism in patients with inflammatory bowel disease (IBD) and the relationship between osteoporosis and the reduction of bone mass so as to identify the risk factors for osteoporosis in IBD. Methods Sixty-nine patients with IBD[49 with Crohn disease (CD) and 20 with ulcerative colitis (UC)] and 20 sex- and age-matched healthy subjects (control group) from the medical examination centre in 2007 were enrolled in the study. The disease activity was estimated according to CD active index and Truelove-Witts score. The biochemical markers of bone metabolism including ostecalcin (OC), 25-bydroxycholecalciferol[-25 (OH)Ds-] and cross-linked N-telopeptides of type I collagen(NTX) were tested using enzyme immunoassay. The body mass index (BMI) and bone mineral density (BMD) were also measured. Results The concentration of 25(OH)D3 was significantly lower in both CD[(44.45±39.38) nmol/L] and UC patients[(34.67±23.79) nmol/L] compared with controls[(98.42±25.84) nmol/L] (P <0.05), while NTX level was significantly higher in both CD [(58.41±15.15) nmol BCE/mmol Cr] and UC[(57. 67±10. 75) nmol BCE/mmol Cr] patients compared with controls[(30. 38±13.35) nmol BCE/mmol Cr] (P<0.05). The levels of OC and 25 (OH)D3 in patients treated with steroids[(17. 3±13. 43) ng/ml and (26. 99 ± 9. 12) nmol/L, respectively] were lower than those in patients untreated with steroids[(27.33 ± 16.86) ng/ml and (45.33±39.03) nmol/L,respectively] . BMD examination revealed that the incidence of osteoporosis in CD or UC groups were 14.3%(7/49) or 3/20,respectively, with no difference between two groups (P>0. 05). The T score of lumbar spine in patients treated with steroids (-1.19±0. 93) was significantly lower than that in patients untreated with steroids (-0.80±1.29) (P<0.05), but there was no difference in T score of femoral between two groups (P>0.05). Stepwise regression analysis revealed that advanced age and reduced BMI were risk factors for osteoporosis in CD patients.Conclusions The lower BMI in patients with IBS contributes to prevalence of osteoporosis, and advanced age and reduced BMI are risk factors for osteoporosis in CD patients. NTX and 25 (OH)D3are important bone metabolic markers to predict osteoporosis in patients with IBD.
