What nutritional factors influence bone mineral density in Crohn's disease patients?

Abstract

Background/AimsBone mineral density (BMD) is often low in patients with Crohn's disease (CD). This study aimed to evaluate the association between nutritional factors and BMD in a group of CD patients.MethodsCD patients 18 years of age or older were included. The body mass index (BMI), waist circumference (WC) and dietary intake were evaluated during two 24-hour recalls. Bone densitometry was performed by dual-energy X-ray absorptiometry of the full body to assess body composition and of the lumbar vertebrae and femoral neck to assess BMD.ResultsIn the 60 patients evaluated, there was no association between BMD and disease activity or between BMD and disease duration. We observed moderate correlations between BMD in at least one of the evaluated sites and BMI, lean mass, WC, and protein, calcium, phosphorus and magnesium dietary intakes (P<0.05). In the linear regression analysis for spinal BMD, only BMI and calcium dietary intake remained associated (P<0.05). In the linear regression analysis for femoral BMD, WC and phosphorus intake continued to be significant in the final model, although they had low explanatory power for BMD (P<0.05).ConclusionsThe prevalence of low BMD was high in CD patients. BMI, WC, calcium and phosphorus dietary intake were positively correlated with BMD.

Serum N-terminal telopeptide of type I collagen as a biomarker for predicting bone density loss in patients with Crohn disease

“…Although in vitro and animal studies suggest that inflammatory cytokines affect BMD, there is insufficient evidence on the relationship between the two in CD patients [ 31 – 33 ]. Although there are differences in the study conditions, some reports have indicated a relationship between the CRP level and BMD, whereas others have indicated that increased concentrations of inflammatory biomarkers are not a risk factor for BMD reduction; therefore, an effective consensus has not been achieved [ 34 – 37 ]. In this study, because CRP levels tended to be higher in the ΔZ-score <0 group, we speculate that the BMD may have decreased due to an inflammatory reaction.…”

Serum N-Terminal Telopeptide of Type I Collagen as a Biomarker for Predicting Bone Density Loss in Patients with Crohn Disease

“…Although in vitro and animal studies suggest that in ammatory cytokines affect BMD, there is insu cient evidence on the relationship between the two in CD patients [31][32][33]. Although there are differences in the study conditions, some reports have indicated a relationship between the CRP level and BMD, whereas others have indicated that increased concentrations of in ammatory biomarkers are not a risk factor for BMD reduction; therefore, an effective consensus has not been achieved [34][35][36][37]. In this study, because CRP levels tended to be higher in the ΔZ-score < 0 group, we speculate that the BMD may have decreased due to an in ammatory reaction.…”

Osteoporosis Complications in Crohn's Disease Patients: Factors, Pathogenesis, and Treatment Outlines

“…The study involved the evaluation of body mass index and waist circumference and performing a DEXA scan of the whole body, specifically the lumbar vertebrae and femoral neck. They concluded that patients with a prolonged gastrointestinal condition such as a CD along with nutritional factor deficiency are at an increased risk of developing osteopenia and osteoporosis [ 10 ]. Andreassen et al reported that many studies and publications were conducted on vitamin D and calcium deficiency and metabolic bone disease in CD, while few studies pointed to vitamin K deficiency.…”

“…Malnutrition is another factor in osteoporosis. CD leads to malabsorption of dietary nutrients such as iron, vitamin B12, vitamin C, vitamin K, vitamin D, phosphorous, zinc, and potassium [ 10 ]. Vitamin D and calcium play an essential role in bone metabolism and homeostasis.…”