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Femoral neck osteopenia in patients with inflammatory bowel disease.
Am J Gastroenterol 1998; 93(9):1483-90AJ

Abstract

OBJECTIVE

The mechanism of bone loss in patients with inflammatory bowel disease (IBD) is not completely understood. The aim of this study was to assess indices of bone turnover and bone mineral density (BMD) in the lumbar spine and femoral neck in IBD patients.

METHODS

Sixty-three patients with Crohn's disease and 41 with ulcerative colitis were studied. Serum bone-specific alkaline phosphatase (B-ALP), osteocalcin, parathyroid hormone (PTH), 25 hydroxyvitamin D, interleukin-6 (IL-6), and urinary N-telopeptide cross linked type 1 collagen (NTX) were determined. BMD of the lumbar spine and femoral neck was determined by dual x-ray absorptiometry in 59 patients.

RESULTS

In the femoral neck 42% of the patients had osteopenia (-2.5 SD < BMD T score < -1 SD) and another 41% had osteoporosis (BMD T score < -2.5). In the spine 34% of the patients had osteopenia and additional 42% had osteoporosis. BMD T scores were lower in the femoral neck compared to the spine. Reduced BMD was unrelated to gender, disease type, lifetime corticosteroid dose, but inversely correlated with disease duration (r = -0.36, p < 0.05). Serum IL-6 was higher in IBD patients compared to controls. A reduced level of osteocalcin, a marker of bone formation, was present in 7% of patients and an increase in NTX, a marker of bone resorption, in 25% of them. Osteoporotic IBD patients (spine or hip BMD T score < -2.5) had increased serum IL-6, osteocalcin and PTH level compared to nonosteoporotic patients.

CONCLUSIONS

There is a high prevalence of reduced BMD at the spine and femoral neck in IBD patients, which is more severe in the hip. Bone turnover in osteoporotic IBD patients is associated with an increase in osteocalcin, PTH and IL-6. IL-6 may play a role in the pathogenesis of bone loss in IBD.

Authors+Show Affiliations

Department of Medicine, Hadassah University Hospital on Mount Scopus, Jerusalem, Israel.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

9732930

Citation

Pollak, R D., et al. "Femoral Neck Osteopenia in Patients With Inflammatory Bowel Disease." The American Journal of Gastroenterology, vol. 93, no. 9, 1998, pp. 1483-90.
Pollak RD, Karmeli F, Eliakim R, et al. Femoral neck osteopenia in patients with inflammatory bowel disease. Am J Gastroenterol. 1998;93(9):1483-90.
Pollak, R. D., Karmeli, F., Eliakim, R., Ackerman, Z., Tabb, K., & Rachmilewitz, D. (1998). Femoral neck osteopenia in patients with inflammatory bowel disease. The American Journal of Gastroenterology, 93(9), pp. 1483-90.
Pollak RD, et al. Femoral Neck Osteopenia in Patients With Inflammatory Bowel Disease. Am J Gastroenterol. 1998;93(9):1483-90. PubMed PMID: 9732930.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Femoral neck osteopenia in patients with inflammatory bowel disease. AU - Pollak,R D, AU - Karmeli,F, AU - Eliakim,R, AU - Ackerman,Z, AU - Tabb,K, AU - Rachmilewitz,D, PY - 1998/9/11/pubmed PY - 1998/9/11/medline PY - 1998/9/11/entrez SP - 1483 EP - 90 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 93 IS - 9 N2 - OBJECTIVE: The mechanism of bone loss in patients with inflammatory bowel disease (IBD) is not completely understood. The aim of this study was to assess indices of bone turnover and bone mineral density (BMD) in the lumbar spine and femoral neck in IBD patients. METHODS: Sixty-three patients with Crohn's disease and 41 with ulcerative colitis were studied. Serum bone-specific alkaline phosphatase (B-ALP), osteocalcin, parathyroid hormone (PTH), 25 hydroxyvitamin D, interleukin-6 (IL-6), and urinary N-telopeptide cross linked type 1 collagen (NTX) were determined. BMD of the lumbar spine and femoral neck was determined by dual x-ray absorptiometry in 59 patients. RESULTS: In the femoral neck 42% of the patients had osteopenia (-2.5 SD < BMD T score < -1 SD) and another 41% had osteoporosis (BMD T score < -2.5). In the spine 34% of the patients had osteopenia and additional 42% had osteoporosis. BMD T scores were lower in the femoral neck compared to the spine. Reduced BMD was unrelated to gender, disease type, lifetime corticosteroid dose, but inversely correlated with disease duration (r = -0.36, p < 0.05). Serum IL-6 was higher in IBD patients compared to controls. A reduced level of osteocalcin, a marker of bone formation, was present in 7% of patients and an increase in NTX, a marker of bone resorption, in 25% of them. Osteoporotic IBD patients (spine or hip BMD T score < -2.5) had increased serum IL-6, osteocalcin and PTH level compared to nonosteoporotic patients. CONCLUSIONS: There is a high prevalence of reduced BMD at the spine and femoral neck in IBD patients, which is more severe in the hip. Bone turnover in osteoporotic IBD patients is associated with an increase in osteocalcin, PTH and IL-6. IL-6 may play a role in the pathogenesis of bone loss in IBD. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/9732930/Femoral_neck_osteopenia_in_patients_with_inflammatory_bowel_disease_ L2 - http://Insights.ovid.com/pubmed?pmid=9732930 DB - PRIME DP - Unbound Medicine ER -