Bone density and bone metabolism in patients with inflammatory bowel disease

Shirazi, K. M. and Somi, M. H. and Rezaeifar, P. and Fattahi, I. and Khoshbaten, M. and Ahmadzadeh, M. (2012) Bone density and bone metabolism in patients with inflammatory bowel disease. Saudi Journal of Gastroenterology, 18 (4). pp. 241-247.

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Background/Aims: Patients with inflammatory bowel disease (IBD) are at high risk for low bone mineral density (BMD). This study aimed to evaluate BMD in IBD patients and its relationship with bone metabolism in a group of Iranian patients. Patients and Methods: A cross-sectional study was conducted on patients with IBD to assess BMD status and serum biochemical factors. After getting the demographic data from 200 patients, they were screened using dual-energy X-ray absorptiometry of the lumbar spine (L2-L4) and femoral neck for BMD status. Serum levels of calcium, phosphate, alkaline phosphatase (ALP), and 25-hydroxyvitamin D (25-OH vitamin D) were measured to assess the bone metabolism status. Results: Two hundred patients with IBD were enrolled in the study. One hundred and eighty three (91.5) patients were identified as having ulcerative colitis (UC) and 17 (8.5) as having Crohn′s disease (CD). Based on the lumbar and femoral neck bone mass densitometry, 148 (74.4) patients had low BMD at either lumbar spine or femoral neck. Of these, 100 patients (50.3) were osteopenic and 48 patients (24.1) were osteoporotic. A 58.6 and 61 of patients with UC had low BMD in the lumbar and femoral neck, respectively. These results for those with CD were 76.5 and 70.6, respectively. The mean of femoral neck and lumbar T-scores in patients with UC were -1.14 and -1.38, and in patients with CD were -1.24 and -1.47, respectively (P > 0.05). The mean (SD) levels for calcium (Ca) in UC and CD were in the normal range. The mean (SD) levels of ALP and 25-OH vitamin D in both the groups were in the normal range, and in comparison between groups (UC and CD), no significant differences were observed (P = 0.20 for ALP and P = 0.44 for 25-OH vitamin D). In the assessment of correlation between biochemical markers and BMD, an inverse correlation between lumbar T-score and ALP or 25-OH vitamin D only in patients with UC was observed. Conclusions: The high prevalence of low BMD in the Iranian population with IBD needs attention. The subclinical vitamin D deficiency may contribute to bone loss in IBD patients, which is more pronounced in patients with UC in this study because of the small population of patients with CD.

Item Type: Article
Additional Information: Cited By :11 Export Date: 16 February 2020 Correspondence Address: Rezaeifar, P.; Liver and Gastrointestinal Diseases Research Center(LGDRC), Tabriz University of Medical Sciences, Imam Reza Hospital, Tabriz, Iran; email:
Uncontrolled Keywords: Inflammatory bowel disease osteopenia osteoporosis 25 hydroxyvitamin D alkaline phosphatase calcium phosphate adult aged alkaline phosphatase blood level article biochemistry bone densitometry bone density bone metabolism calcium blood level controlled study correlational study Crohn disease cross-sectional study demography dual energy X ray absorptiometry enteritis female femur neck human Iran lumbar spine major clinical study male phosphate blood level ulcerative colitis vitamin D deficiency Absorptiometry, Photon Adolescent Age Factors Bone Diseases, Metabolic Cohort Studies Colitis, Ulcerative Cross-Sectional Studies Diet Humans Middle Aged Risk Factors Sex Factors Young Adult
Subjects: WE Musculoskeletal system
WI Digestive System
Divisions: Mashhad University of Medical Sciences
Depositing User: mr lib5 lib5
Date Deposited: 11 Apr 2020 07:45
Last Modified: 11 Apr 2020 07:45

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