Abstract
BackgroundMicroscopic colitis presents with similar symptoms to classic inflammatory bowel diseases. Osteoporosis is a common complication of Crohn's disease but there are no data concerning bone metabolism in microscopic colitis.AimsThe aim of the present study was to evaluate bone density and metabolism in patients with microscopic colitis.MethodsFourteen patients microscopic colitis were included in the study, and 28 healthy persons and 28 age and gender matched Crohn's disease patients were enrolled as controls. Bone mineral density was measured using dual x-ray absorptiometry at the lumbar spine, femoral neck and the radius. Serum bone formation and bone resorption markers (osteocalcin and beta-crosslaps, respectively) were measured using immunoassays.ResultsLow bone mass was measured in 57.14% patients with microscopic colitis. Bone mineral density at the femoral neck in patients suffering from microscopic colitis and Crohn's disease was lower than in healthy controls (0.852 ± 0.165 and 0.807 ± 0.136 vs. 1.056 ± 0.126 g/cm2; p < 0.01). Bone mineral density at the non-dominant radius was decreased in microscopic colitis patients (0.565 ± 0.093 vs. 0.667 ± 0.072 g/cm2; p < 0.05) but unaffected in Crohn's disease patients (0.672 ± 0.056 g/cm2). Mean beta-crosslaps concentration was higher in microscopic colitis and Crohn's disease patients than controls (417.714 ± 250.37 and 466.071 ± 249.96 vs. 264.75 ± 138.65 pg/ml; p < 0.05). A negative correlation between beta-crosslaps concentration and the femoral and radius t-scores was evident in microscopic colitis patients.ConclusionsLow bone mass is frequent in microscopic colitis, and alterations to bone metabolism are similar to those present in Crohn's disease. Therefore, microscopic colitis-associated osteopenia could be a significant problem in such patients.
Highlights
Microscopic colitis presents with similar symptoms to classic inflammatory bowel diseases
Low bone mass is frequent in microscopic colitis, and alterations to bone metabolism are similar to those present in Crohn’s disease
Microscopic colitis-associated osteopenia could be a significant problem in such patients
Summary
Microscopic colitis presents with similar symptoms to classic inflammatory bowel diseases. Osteoporosis is a common complication of Crohn’s disease but there are no data concerning bone metabolism in microscopic colitis. Macroscopically normal colonic mucosa is evident on radiological and endoscopic examination, and microscopic examination is required for the detection of diagnostic histopathological features [1,2]. MC normally occurs in middle-aged patients, with a peak incidence in individuals aged approximately 65 years. Diagnostic criteria for lymphocytic colitis (LC) are more than 10 [9] or 20 [10] intraepithelial lymphocytes (IEL)/ 100 epithelial cells of the colonic mucosa. There is a high incidence of spontaneous resolution of symptoms, and budesonide is the drug of choice for first-line treatment in patients with severe symptoms [13]
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