How Activity of Inflammatory Bowel Disease Influences Bone Loss

Orlić, Željka Crnčević; Turk, Tamara; Sinčić, Brankica Mijandrušić; Stimac, Davor; Cvijanović, Olga; Marić, Ivana; Tomaš, Maja Ilić; Jurišić‐Eržen, Dubravka; Licul, Vanja; Bobinac, Dragica

doi:10.1016/j.jocd.2009.12.002

Cited by 6 publications

(8 citation statements)

References 39 publications

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“…[8] The higher prevalence of bone disease in CD is thought to result from ileal and small intestinal involvement, ileal resection, hepatobiliary complications, and the use of cholestyramine, which can lead to vitamin D deficiency, calcium malabsorption, or malnutrition. [35] Our study, similar to others,[81036] failed to demonstrate a difference in the frequency of bone loss between the CD and UC patients.…”

Section: Discussionsupporting

confidence: 90%

Frequency of low bone mineral density in Saudi patients with inflammatory bowel disease

Ismail

Al-Elq

Al-Jarodi

et al. 2012

Saudi J Gastroenterol

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Background/Aims:Metabolic bone disease is common in patients with inflammatory bowel disease (IBD). Our aim was to determine the frequency of bone loss among Saudi patients with IBD and possible contributing risk factors.Settings and Design:We retrospectively reviewed Saudi patients with IBD, between 18 and 70 years of age, who had bone mass density (BMD) determined by dual-energy X-ray absorptiometry scanning at one of three hospitals in the Kingdom of Saudi Arabia from 2001 to 2008.Patients and Methods:Case notes and BMDs results were carefully reviewed for demographic and clinical data. Low bone mass, osteopenia, and osteoporosis were defined according to the WHO guidelines.Statistical Analysis Used:Predictive factors for BMD were analyzed using group comparisons and stepwise regression analyses.Results:Ninety-five patients were included; 46% had Crohn's disease (CD) and 54% had ulcerative colitis (UC). The average age was 30.9±11.6 years. Using T-scores, the frequency of osteopenia was 44.2%, and the frequency of osteoporosis was 30.5% at both lumbar spine and proximal femur. Only 25.3% of patients exhibited a BMD within the normal range. Our results revealed a positive correlation between the Z-score in both the lumbar spine and the proximal femur and body mass index (BMI) (P=0.042 and P=0.018, respectively). On regression analysis BMI, age, and calcium supplementation were found to be the most important independent predictors of BMD.Conclusions:Saudi patients with IBD are at an increased risk of low BMD and the frequency of decreased BMD in Saudi patients with CD and UC were similar. BMI and age were the most important independent predictors of low BMD.

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Section: Discussionsupporting

confidence: 90%

Frequency of low bone mineral density in Saudi patients with inflammatory bowel disease

Ismail

Al-Elq

Al-Jarodi

et al. 2012

Saudi J Gastroenterol

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“…D'autres facteurs liés au terrain tel que l'age [1, 9, 13], le sexe [8, 13], le tabagisme [17, 18], et l'apport calcique quotidien [1, 13], ont été recherché, mais les résultats étaient discordants. Dans notre travail nous n'avons pas retrouvé de relation entre ces facteurs et la perte osseuse.…”

Section: Discussionunclassified

“…Cette hypothèse est retenue devant la corrélation entre l'activité de la maladie et la densité minérale osseuse et l'implication des prostaglandines et de certaines cytokines pro inflammatoires comme l'IL1, l'IL6 ou le TNF ' dont l'expression est augmentée dans les MICI et qui ont un rôle clé dans le métabolisme osseux, en favorisant la résorption osseuse. La plupart des études de la littérature dont la notre [8, 14], ont démontré que l'activité clinique ou biologique sont des critères prédictifs de perte osseuse au cours des MICI.…”

Section: Discussionunclassified

“…Ceci n'a pas été retrouvé dans notre étude. Le type de MICI ne semble pas influencer la perte osseuse, La plupart des études, convergent vers l'absence de différence statistiquement significative entre les DMO des malades atteints de RCH de celles des patients ayant une MC [1, 8, 9]. De même, pour le siège et la forme de la maladie, le nombre de poussée, et la notion de resection intestinale.…”

Section: Discussionunclassified

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La baisse de la densité osseuse au cours des maladies inflammatoires chroniques de l’intestin : prévalence et facteurs de risque

Slama¹,

Abdellaoui²,

Ksiaa³

et al. 2013

Pan Afr Med J

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IntroductionLa baisse de la densité minérale osseuse représente la principale manifestation osseuse décrite au cours des maladies inflammatoires chroniques de l'intestin. En Tunisie, très peu d’études ont rapportés sa prévalence et ses facteurs de risque. Le but de ce travail était de déterminer la prévalence de la perte osseuse au cours des maladies inflammatoires chroniques de l'intestin, et rechercher ses facteurs de risque.MéthodesPatients et méthodes: étude ouverte transversale, réalisée de 2007 jusqu’à 2012.Résultats146 cas étaient colligés, dont 105 avaient une maladie de Crohn (71,9%) et 41 avaient une rectocolite hémorragique (28,1%). Il s'agissait de 62 hommes et 84 femmes. L’âge moyen était de 33,18 ans. La perte osseuse était trouvée chez 85 patients (58,2%). Il s'agissait d'une ostéopénie dans 57 cas et d'ostéoporose dans 28 cas. Les facteurs de risque de perte osseuse étaient une activité physique limitée (p=0,013), un indice de masse corporel ‘20 kg/m2 (p=0,015), une maladie active (p=0,035), l’étendue de l'atteinte intestinale (p=0,006) et une dose cumulée de corticothérapie dépassant 4,5g de Prednisone (p=0,003).ConclusionLa déminéralisation osseuse est une complication fréquente mais non constante. Ceci justifie un dépistage précoce chez les patients à risque, qui pourront ainsi bénéficier d'un traitement substitutif.

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“…Based on animal and in vitro observations [23]–[27], recent studies have raised the attention on the interplay between inflammatory factors and bone remodeling and metabolism not only in SLE [2], [16], [28], [29], but also in other clinical conditions, such as Rheumatoid Arthritis, Inflammatory Bowel Disease, Idiopathic Hypercalciuria and Estrogen withdrawal [24], [26], [30]–[34]. There are many evidences that the immune and skeletal systems not only share a number a regulatory molecules (such as cytokines, receptors, signaling and transcription factors), but also interact in the bone marrow [35].…”

Section: Introductionmentioning

confidence: 99%

Bone Disease in Newly Diagnosed Lupus Nephritis Patients

et al. 2014

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IntroductionBone loss in Lupus Nephritis (LN) patients is common and multifactorial. The aim of this study was to evaluate the bone status of newly diagnosed LN patients and their correlation with inflammatory factors involved in LN physiopathology.MethodsWe studied 15 pre-menopausal patients with ≤2 months of diagnosed SLE and LN. Patients with prior kidney or bone disease were excluded. In addition to biochemical evaluation (including 25-hydroxyvitamin D3 [25(OH)D] and Monocyte Chemotactic Protein (MCP1) dosage), we performed bone biopsies followed by osteoblast culture, histomorphometric and immunohistochemistry analysis.ResultsLN patients presented a mean age of 29.5±10 years, a proteinuria of 4.7±2.9 g/day and an estimated glomerular filtration rate (GFR) of 37(31–87) ml/min/1,73 m2. They were on glucocorticoid therapy for 34±12 days. All patients presented vitamin D insufficiency (9.9±4.4 ng/ml, range 4–20). Urinary MCP1 correlated negatively with 25(OH)D (r = −0.53, p = 0.003) and positively with serum deoxypyridinoline (r = 0.53, p = 0.004). Osteoblasts isolated from LN bone biopsies presented a significantly higher expression of MCP-1 when compared to controls (32.0.±9.1 vs. 22.9±5.3 mean fluorescence intensities, p = 0.01). LN patients presented a significantly reduced osteoid volume, osteoid thickness, osteoid surface, mineralization surface and bone formation rate, associated with an increased eroded surface and osteoclast surface. Patient’s bone specimens demonstrated a reduced immunostaining for osteoprotegerin (0.61±0.82 vs. 1.08±0.50%, p = 0.003), and an increased expression of Receptor Activator of NF-κB ligand (RANKL) (1.76±0.92 vs. 0.41±0.28%, p<0.001) when compared to controls.DiscussionNewly diagnosed LN patients presented a significant disturbance in bone metabolism, characterized by an impaired bone formation and mineralization, associated with an increase in resorption parameters. Glucocorticoid use, vitamin D insufficiency and inflammation might be involved in the physiopathology of bone metabolism disturbance.

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How Activity of Inflammatory Bowel Disease Influences Bone Loss

Cited by 6 publications

References 39 publications

Frequency of low bone mineral density in Saudi patients with inflammatory bowel disease

Frequency of low bone mineral density in Saudi patients with inflammatory bowel disease

La baisse de la densité osseuse au cours des maladies inflammatoires chroniques de l’intestin : prévalence et facteurs de risque

Bone Disease in Newly Diagnosed Lupus Nephritis Patients

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