OSTEOPENIA IN INFLAMMATORY BOWEL DISEASES

53 unselected patients with Crohn's disease (CD) (35 female, 18 men; m ean age: 32.3 +/- 12.5 y.; mean duration of CD: 78.6 +/- 65.7 months) and 23 patients with ulcerative colitis (UC) (8 female, 15 men; mean a ge: 43.7 +/- 17.9 y.; mean duration of UC: 100.7 +/- 86.0 months) were examined by quantitative computertomography (lumbar spine 1-3). Incip ient (manifest) osteopenia (OP) was defined as a reduced axial bone mi neral density ty from - 1 standard deviatons (SD) to - 2 (SD) (<-2SD) as compared to a control Group. Reduced bone mineral density was found in 30.2% (16/53) of patients with CD and 9% (2/23) with UC (p < 0.05) In particular 12/53 pts. (22.6%) with CD and 1/23 pts. (4.35%) with U C showed incipient OP, whereas 4/53 pts. (7.5%) CD and 1/23 pts. (4.35 %) with UC showed manifest OP. With respect to the location of CD the mean relative bone density (SD) was found to be significantly lower in patients with ileal in involvement of CD (-0.88 +/- 0.8 SD; n=39) as compared to patients with colonic involvement (-0.09 +/- 0.86 SD; n=14 ) and UC (-0.09 +/- 0.55 SD; n=23) (p < 0.05). No significant correlat ion to the duration of the disease was found. Previous therapy with st eriods led to lower-mineral bone density as compared to untreated pati ents. As a trend duration of steroid treatment and bone density were s hown to be correlated inversely. Patients with OP in CD showed the fol lowing characteristic 100% were pretreated with steroids (73% of them > 12 weeks); 93.7% showed ileal involvement CP; 75% of these patients were women (81.8% of them premenopausal); 43.7% showed a. previously r esection of the terminal ileum; 31.2% showed a reduced: body weight (< 10% compared to normal body: weight); 21.4% showed intolerance for la ctose. Patients with low mineral bone density showed a Significant inc rease of parathormone as compared to patients with normal bone density (306.8 +/- 90.1 vs. 221.7 +/- 50.7 ng/l; p < 0.05). The etiology of O P in IBD seems to depend on several factors like malnutrition, malabso rption, reduced body weight, ileal involvement, steroid therapy and se x. Our data indicate ileal involvement of CD to be the most important factor to explain the differences between CD and UC. Steroid therapy i s another risk factor for OP. We suggest the long-term follow up of pa tients with risk factors.