Abstract
Inflammatory bowel disease (IBD) patients have a significant risk of developing bone loss. The trabecular bone score (TBS) is a relatively new parameter used to provide information on bone quality. The study cohort included 81 patients with IBD and 81 healthy controls. Blood tests, dual-energy x-ray absorptiometry (DXA), including TBS, were assessed. Harvey–Bradshaw Index (HBI) for Crohn's disease (CD) and the Partial Mayo Score for ulcerative colitis (UC) were used for evaluation of clinical disease activity. Compared with the healthy controls, the IBD patients had lower lumbar spine (LS) bone mineral density (BMD) (1.06 ± 0.18 vs. 1.16 ± 0.15 g/cm2, p < 0.005), hip BMD (0.88 ± 0.13 vs. 0.97 ± 0.13 g/cm2, p < 0.005) and TBS (1.38 ± 0.1 vs. 1.43 ± 0.1, p < 0.005) values. The patients with stricturing CD had lower TBS (1.32 ± 0.13 vs. 1.40 ± 0.9, p = 0.03) and LS BMD (0.92 ± 0.19 vs. 1.07 ± 0.1, p = 0.01) values compared with those with non-stricturing CD. Multivariate regression model analysis identified HBI as independent factor associated with TBS. Our results support that all DXA parameters are lower in patients with IBD than in healthy patients. Moreover, TBS is a valuable tool for assessment of bone impairment in active CD.
Highlights
Inflammatory bowel disease (IBD) patients have a significant risk of developing bone loss
The Z and T scores are used to establish the diagnosis of osteoporosis, osteopenia or low bone mineral density (BMD) according to the 2019 International Society of Clinical Densitometry official position for adults[4]
A cross-sectional study with 81 IBD patients (48 with Crohn’s disease (CD) and 33 with ulcerative colitis (UC)) and 81 healthy controls was conducted at the Elias Hospital Department of Endocrinology
Summary
Inflammatory bowel disease (IBD) patients have a significant risk of developing bone loss. Compared with the healthy controls, the IBD patients had lower lumbar spine (LS) bone mineral density (BMD) (1.06 ± 0.18 vs 1.16 ± 0.15 g/cm[2], p < 0.005), hip BMD (0.88 ± 0.13 vs 0.97 ± 0.13 g/cm[2], p < 0.005) and TBS (1.38 ± 0.1 vs 1.43 ± 0.1, p < 0.005) values. The trabecular bone score (TBS) was developed out of the need for a less complicated and non-invasive surrogate p arameter[6] This index is a greyscale textural analytical tool that measures lumbar spine (LS) DXA and BMD-independent predictors for both skeletal strength and risk of fractures. The objectives of this study were to evaluate and compare both bone quality (as assessed by TBS) and quantity (as assessed by BMD) in patients with IBD and healthy controls as well as to describe the usefulness of the TBS in IBD bone impairment
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