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Reduced bone mass and preserved marrow adipose tissue in patients with inflammatory bowel diseases in long-term remission.
Osteoporos Int. 2017 07; 28(7):2167-2176.OI

Abstract

Bone marrow adipose tissue has not been studied in patients with inactive inflammatory bowel disease. We found that these patients have preserved marrow adiposity even with low bone mass. Factors involved in bone loss in active disease may have long-lasting effects but do not seem to affect bone marrow adiposity.

INTRODUCTION

Reduced bone mass is known to occur at varying prevalence in patients with inflammatory bowel diseases (IBD) because of inflammation, malnutrition, and steroid therapy. Osteoporosis may develop in these patients as the result of an imbalanced relationship between osteoblasts and adipocytes in bone marrow. This study aimed to evaluate for the first time bone mass and bone marrow adipose tissue (BMAT) in a particular subgroup of IBD patients characterized by long-term, steroid-free remission.

METHODS

Patients with Crohn's disease (CD; N = 21) and ulcerative colitis (UC; N = 15) and controls (C; N = 65) underwent dual X-ray energy absorptiometry and nuclear magnetic resonance spectroscopy of the L3 lumbar vertebra for BMAT assessment.

RESULTS

Both the CD and UC subgroups showed significantly higher proportions of patients than controls with Z-score ≤-2.0 at L1-L4 (C 1.54%; CD 19.05%; UC 20%; p = 0.02), but not at other sites. The proportions of CD patients with a T-score ˂-1.0 at the femoral neck (C 18.46%; CD 47.62%; p = 0.02) and total hip (C 16.92%; CD 42.86%; p = 0.03) were significantly higher than among controls. There were no statistically significant differences between IBD patients and controls regarding BMAT at L3 (C 28.62 ± 8.15%; CD 29.81 ± 6.90%; UC 27.35 ± 9.80%; p = 0.67).

CONCLUSIONS

IBD patients in long-term, steroid-free remission may have a low bone mass in spite of preserved BMAT. These findings confirm the heterogeneity of bone disorders in IBD and may indicate that factors involved in bone loss in active disease may have long-lasting effects on these patients.

Authors+Show Affiliations

Gastroenterology Division, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Av Bandeirantes 3900, Ribeirão Preto, SP, 14049-900, Brazil. bastosclara@yahoo.com.br.Endocrinology Division, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.Radiology Division, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.Department of Physics, Ribeirão Preto Faculty of Philosophy, Sciences and Letters, University of São Paulo, Ribeirão Preto, Brazil.Endocrinology Division, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.Gastroenterology Division, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Av Bandeirantes 3900, Ribeirão Preto, SP, 14049-900, Brazil.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28405731

Citation

Bastos, C M., et al. "Reduced Bone Mass and Preserved Marrow Adipose Tissue in Patients With Inflammatory Bowel Diseases in Long-term Remission." Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, vol. 28, no. 7, 2017, pp. 2167-2176.
Bastos CM, Araújo IM, Nogueira-Barbosa MH, et al. Reduced bone mass and preserved marrow adipose tissue in patients with inflammatory bowel diseases in long-term remission. Osteoporos Int. 2017;28(7):2167-2176.
Bastos, C. M., Araújo, I. M., Nogueira-Barbosa, M. H., Salmon, C. E. G., de Paula, F. J. A., & Troncon, L. E. A. (2017). Reduced bone mass and preserved marrow adipose tissue in patients with inflammatory bowel diseases in long-term remission. Osteoporosis International : a Journal Established as Result of Cooperation Between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA, 28(7), 2167-2176. https://doi.org/10.1007/s00198-017-4014-3
Bastos CM, et al. Reduced Bone Mass and Preserved Marrow Adipose Tissue in Patients With Inflammatory Bowel Diseases in Long-term Remission. Osteoporos Int. 2017;28(7):2167-2176. PubMed PMID: 28405731.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Reduced bone mass and preserved marrow adipose tissue in patients with inflammatory bowel diseases in long-term remission. AU - Bastos,C M, AU - Araújo,I M, AU - Nogueira-Barbosa,M H, AU - Salmon,C E G, AU - de Paula,F J A, AU - Troncon,L E A, Y1 - 2017/04/12/ PY - 2016/09/17/received PY - 2017/03/15/accepted PY - 2017/4/14/pubmed PY - 2018/7/10/medline PY - 2017/4/14/entrez KW - Bone marrow adipose tissue KW - Bone mass KW - Crohn’s disease KW - Inflammatory bowel diseases KW - Ulcerative colitis SP - 2167 EP - 2176 JF - Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA JO - Osteoporos Int VL - 28 IS - 7 N2 - : Bone marrow adipose tissue has not been studied in patients with inactive inflammatory bowel disease. We found that these patients have preserved marrow adiposity even with low bone mass. Factors involved in bone loss in active disease may have long-lasting effects but do not seem to affect bone marrow adiposity. INTRODUCTION: Reduced bone mass is known to occur at varying prevalence in patients with inflammatory bowel diseases (IBD) because of inflammation, malnutrition, and steroid therapy. Osteoporosis may develop in these patients as the result of an imbalanced relationship between osteoblasts and adipocytes in bone marrow. This study aimed to evaluate for the first time bone mass and bone marrow adipose tissue (BMAT) in a particular subgroup of IBD patients characterized by long-term, steroid-free remission. METHODS: Patients with Crohn's disease (CD; N = 21) and ulcerative colitis (UC; N = 15) and controls (C; N = 65) underwent dual X-ray energy absorptiometry and nuclear magnetic resonance spectroscopy of the L3 lumbar vertebra for BMAT assessment. RESULTS: Both the CD and UC subgroups showed significantly higher proportions of patients than controls with Z-score ≤-2.0 at L1-L4 (C 1.54%; CD 19.05%; UC 20%; p = 0.02), but not at other sites. The proportions of CD patients with a T-score ˂-1.0 at the femoral neck (C 18.46%; CD 47.62%; p = 0.02) and total hip (C 16.92%; CD 42.86%; p = 0.03) were significantly higher than among controls. There were no statistically significant differences between IBD patients and controls regarding BMAT at L3 (C 28.62 ± 8.15%; CD 29.81 ± 6.90%; UC 27.35 ± 9.80%; p = 0.67). CONCLUSIONS: IBD patients in long-term, steroid-free remission may have a low bone mass in spite of preserved BMAT. These findings confirm the heterogeneity of bone disorders in IBD and may indicate that factors involved in bone loss in active disease may have long-lasting effects on these patients. SN - 1433-2965 UR - https://www.unboundmedicine.com/medline/citation/28405731/Reduced_bone_mass_and_preserved_marrow_adipose_tissue_in_patients_with_inflammatory_bowel_diseases_in_long_term_remission_ L2 - https://dx.doi.org/10.1007/s00198-017-4014-3 DB - PRIME DP - Unbound Medicine ER -