Osteoporosis In Crohn's Disease Research Articles

Bone mineral density and inflammatory bowel disease severity.

Inflammatory bowel disease (IBD) is associated with low bone mineral density (BMD). In this study, the association between disease severity and BMD in patients with IBD was evaluated. Associations between BMD and the Montreal classification, disease activity and drug therapy were also tested. A cross-sectional prevalence study with a comparison group was conducted. One hundred and twenty-eight patients were evaluated: 68 patients with ulcerative colitis (UC), and 60 with Crohn's disease (CD). The control group consisted of 67 healthy subjects. All patients and controls had BMD measured and in IBD patients, current medications, hospitalization, and disease location, extent and phenotype, according to the Montreal classification, were recorded. Multiple correspondence analysis was applied to evaluate categorical variables. In the CD group, most patients were diagnosed between 17–40 years of age. Ileocolonic and non-stricturing non-penetrating disease were the most frequent disease location and behavior, respectively. In UC patients, extensive colitis was the most frequent disease location. UC and CD patients were more likely to have osteopenia than controls (OR=14.93/OR=24.38, respectively). In the CD group, male patients, perianal disease, penetrating behavior and age at diagnosis >40 years were associated with low BMD. Taking azathioprine and infliximab also seemed to be associated with osteopenia. In the UC group, we observed an association between low BMD and male patients, left colitis, corticosteroid use and hospitalization. Disease activity was not associated with osteopenia or osteoporosis in CD and UC patients. Disease severity seems to be associated with osteopenia in IBD patients.

Assessment of bone metabolism in patients with inflammatory bowel disease

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). 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). 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. Key words: Crohn disease; Colitis, ulcerative; Osteoporosis

Comparison of the effects of 1,25 dihydroxyvitamin D and 25 hydroxyvitamin D on bone pathology and disease activity in Crohnʼs disease patients

Vitamin D is essential for osteopenia therapy in Crohn's disease (CD). The active form of vitamin-D (aVD) is the 1,25(OH)2D. There are no data available whether aVD or plain vitamin-D (pVD) has any advantage in managing osteoporosis in CD or has any effect on the activity of the disease itself. Our work is a prospective study to compare the effects of aVD and pVD on bone metabolism and the clinical course of CD. In all, 37 inactive CD patients were involved in the study and divided into 2 age-, gender-, and t-score-matched groups. Group A was treated with aVD while group B received pVD. Osteocalcin, beta-CrossLaps, osteoprotegerin, and receptor activator nuclear factor kappa-B ligand concentrations were estimated at the start of the study and at 6 weeks and 3 and 12 months. The activity of CD was also measured clinically and by laboratory parameters. At week 6 the Crohn's Disease Activity Index (CDAI) scores and concentration of C-reactive protein decreased (69.44 +/- 58.6 versus 57.0 +/- 54.89 and 15.8 +/- 23.57 mmol/L versus 7.81 +/- 3.91 mmol/L, respectively, P < 0.05) parallel with markers of bone turnover (beta-CrossLaps: 0.46 +/- 0.21 ng/mL versus 0.40 +/- 0.25 ng/mL, and osteocalcin: 32.29 +/- 15.3 ng/mL versus 29.98 +/- 14.14 ng/mL, P < 0.05); however, osteoprotegerin concentration (marker of osteoblast activity) increased (3.96 +/- 2.1 pg/mL versus 4.58 +/- 2.19 pg/mL) in group A, but did not change in group B. Osteocalcin and beta-CrossLaps concentrations changed more significantly by the 3rd month; however, these changes disappeared by the 12th month. According to our study, aVD has a more prominent short-term beneficial effect on bone metabolism and disease activity in CD compared with pVD.

Calcium intake in crohn's disease (CD): Are we meeting the nutritional guidelines?

Aim: To determine whether the British Society of Gastroenterology (BSG) guidelines for the prevention and treatment of osteoporosis in CD are being adhered to.

A role for activated T cells in osteoporosis in Crohn disease

A role for activated T cells in osteoporosis in Crohn disease