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Mutifactorial analysis of risk factors for reduced bone mineral density in patients with Crohn’s disease

World Journal of Gastroenterology 2006年第35期12卷 5680-5686页

作者： sarah a bartram Robert T Peaston David J Rawlings David Walshaw Roger M Francis Nick P Thompson Musculoskeletal unit Freeman HospitalNewcastle-upon-Tyne United Kingdom Department of Biochemistry Freeman Hospital Newcastle-upon-Tyne United Kingdom Regional Medical Physics Department Newcastle General Hospital United Kingdom Dept of Statistics University of Newcastle upon Tyne United Kingdom Musculoskeletal unit Freeman Hospital Newcastle-upon-Tyne United Kingdom Department of Medicine Freeman Hospital Newcastle-upon-Tyne United Kingdom

AIM: To determine the prevalence of osteoporosis in a cohort of patients with Crohn’s disease (CD) and to identify the relative significance of risk factors for osteoporosis. METHODS: Two hundred and fifty-eight unselected patients (92 M, 166 F) with CD were studied. Bone mineral density (BMD) was measured at the lumbar spine and hip by dual X-ray absorptiometry. Bone formation was assessed by measuring bone specific alkaline phosphatase (BSAP) and bone resorption by measuring urinary excretion of deoxypyridinoline (DPD) and N-telopeptide (NTX). RESULTS: Between 11.6%-13.6% patients were osteoporotic (T score < -2.5) at the lumbar spine and/or hip. NTX levels were significantly higher in the patients with osteoporosis (P < 0.05) but BSAP and DPD levels were not significantly different. Independent risk factors for osteoporosis at either the lumbar spine or hip were a low body mass index (P < 0.001), increasing corticosteroid use (P < 0.005), and male sex (P < 0.01). These factors combined accounted for 23% and 37% of the reduction in BMD at the lumbar spine and hip respectively. CONCLUSION: Our results confirm that osteoporosis is common in patients with CD and suggest that increased bone resorption is the mechanism responsible for thebone loss. However, less than half of the reduction in BMD can be attributed to risk factors such as corticosteroid use and low BMI and therefore remains unexplained.

关键词： Crohn's disease Osteoporosis Osteopenia Bone mineral density

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