ALTERED BONE METABOLISM IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE

Abstract

Patients with inflammatory bowel disease (IBD) are at risk of developing metabolic bone disease. We aimed to compare markers of bone metabolism and bone mineral density in patients with IBD and healthy subjects. Seventeen patients with ulcerative colitis (13 women, four men; median age 33.4; range 15–52), and eight patients with Crohn's disease (five women, three men; median age 30.2; range 21–44), and 20 healthy subjects (12 women, eight men; median age 32.5; range 17–52) were investigated.The diagnosis of IBD was based on endoscopical, radiological and histological examinations. Markers of bone metabolism (serum calcium, alkaline phosphatase (AP), osteocalcin, phosphate, parathyroid hormone (PTH), 25‐hydroxy‐vitamin D3 (25‐OH‐D3), and urine deoxyprydoline (DPD) were measured. Bone mineral density of lumbar L2–L4 vertebrae in the anterioposterior projection, femoral neck and Ward's triangle were determined by dual X‐ray absorbtiometry (DXA).While osteocalcine and AP levels (osteoblastic activity parameters) of patients did not differ from those of controls, urine DPD (osteoclastic activity parameter) was higher than that of controls (P < 0.05). Serum PTH and 25‐OH‐D3 levels were also higher in patients (P < 0.05). T scores of bone mineral density were statistically lower in patients than controls (P < 0.001).Osteopenia was observed in 12 patients with IBD (48%), osteoporosis was in five patients (20%). These were significantly higher than controls (14 and 8%, respectively). There was a high prevalence of reduced bone mineral density in patients with IBD which is independent of site, activity or type of disease.