METABOLIC BONE ASSESSMENT IN PATIENTS WITH INFLAMMATORY BOWEL-DISEASE

Background/Aims: Patients with inflammatory bowel disease are at risk for osteopenia. To study the metabolic bone status of these patients, a cross-sectional study was conducted. Methods: Eighty-four patients ( 49 women, 35 men) with inflammatory bowel disease, 34 of whom had Croh n's disease and 50 ulcerative colitis (including 18 with prior colopro ctectomy and ileoanal anastomosis), underwent clinical, dietary, and s pine radiological assessments. Bone metabolism was assessed by measuri ng serum levels of calcium, phosphate, parathyroid hormone (1-84), 25- hydroxyvitamin D-3, 1,25-dihydroxyvitamin D-3, and osteocalcin. Lumbar and femoral neck bone mineral densities were measured by dual energy X-ray absorptiometry. Results: Serum osteocalcin level was decreased i n 29 patients (34%), 12 of whom had never undergone steroid therapy. T he other biochemical markers of bone metabolism were in the normal ran ge. Thirty-six patients (43%) had osteopenia, and 6 patients (7%) had vertebral crush fractures. Osteopenia was observed in 27 patients (52% ) and 9 patients (28%) with and without corticosteroid therapy, respec tively. No patient had clinical or biological signs of osteomalacia. A nalysis of bone density (lumbar Z score) by a multiple regression anal ysis showed a statistically significant correlation with age, cumulati ve corticosteroid doses, sedimentation rate, and osteocalcin level (R( 2) = 0.76; P = 0.05). Conclusions: The results suggest that bone turno ver in inflammatory bowel disease is characterized by low bone formati on in the presence of normal levels of calcium-regulating hormones.