TOTAL-BODY CALCIUM IN WOMEN WITH INFLAMMATORY BOWEL-DISEASE TREATED WITH HORMONE REPLACEMENT THERAPY

Objective: To examine changes in total body calcium and radial and spi nal bone mineral content in peri- and postmenopausal women with inflam matory bowel disease treated with hormone replacement therapy. Design: Follow-up measurements were made over a mean of 2.1 years (range 1.9- 2.3 years). Methods: Sixteen women, with a mean age of 47 years (range 41-57 years), with inflammatory bowel disease underwent repeat measur ements of bone density. Of the 16 women, 10 were postmenopausal, while six were perimenopausal. All patients were given oral conjugated oest rogen 0.625 mg daily; the 13 patients who had not had a hysterectomy w ere also given cyclic progestogen, 150 mu g norgestel, for 12 days eac h month. Total body calcium was measured by prompt gamma neutron activ ation analysis. Radial cortical bone was measured by single photon abs orptiometry and spinal bone by quantitative computed tomography. Resul ts: There was no significant change in total body calcium, radial or s pinal bone density during the study. The mean annual change (95% confi dence intervals) in total body calcium was +1.87% (-2.2 to +6.0%; P=0. 34), in radial bone mineral -0.48% (-1.8 to +0.8%; P=0.44) and in spin al trabecular bone mineral density +0.52% (-0.52 to +2.6%; P=0.60). Th ere were no significant correlations between the rates of change of to tal body calcium, radial or spinal bone density, or between the rates of change and initial values. There was no clear difference between pa tients with Crohn's disease (n = 9) and those with ulcerative colitis (n = 7). Conclusions: These results suggest that hormone replacement t herapy prevents bone loss in peri- and postmenopausal women with infla mmatory bowel disease.