Increase in bone mineral density in strictly treated Crohn's disease patients with concomitant calcium and vitamin D supplementation

Abstract

Background and aimsDecreased bone mineral density (BMD) is common in Crohn's disease (CD) patients. This paper reports on the prevalence of decreased BMD in a referral cohort study of CD-patients next to the change of BMD over time in relation with CD-associated clinical characteristics. Methods205 CD patients of a referral hospital were enrolled between januari 1998-January 2010 when measurement of BMD by dual X-ray absorptiometry (DXA) was available. Follow-up DXA scan was performed in subjects with known risk factors besides Crohn indicative for low BMD. Treatment of CD patients was according to a protocol which is comparable to the current (inter)national guidelines. In osteopenic patients, supplemental vitamin D (800IU) and Calcium (500–1000mg) were prescribed. ResultsMean BMD at baseline was 0.97±0.16gram/cm2 in lumbar spine and 0.87±0.12gram/cm2 in the total hip. At baseline, higher age and low Body Mass Index (BMI), were negatively correlated with BMD. Eighty-four patients underwent a second BMD assessment with a median interval period of 4years (IQR 3–6). A mean annual increase of +0.76% (95%CI: −2.63%; +3.87%) in lumbar spine and +0.43% (95%CI: −2.65% ; +1.11%) in total hip was observed. ConclusionsHigher age, male sex, low BMI, and a higher age at diagnosis of CD were associated with low BMD. Follow-up of BMD in CD patients showed a contraintuitive small increase of BMD at lumbar spine and total hip in CD patients only using supplemental vitamin D and calcium next to strict treatment of CD.