Clinical Research
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 21, 2006; 12(35): 5680-5686
Published online Sep 21, 2006. doi: 10.3748/wjg.v12.i35.5680
Mutifactorial analysis of risk factors for reduced bone mineral density in patients with Crohn’s disease
Sarah A Bartram, Robert T Peaston, David J Rawlings, David Walshaw, Roger M Francis, Nick P Thompson
Sarah A Bartram, Musculoskeletal unit, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom
Robert T Peaston, Department of Biochemistry, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom
David J Rawlings, Regional Medical Physics Department, Newcastle General Hospital, United Kingdom
David Walshaw, Dept of Statistics, University of Newcastle upon Tyne, United Kingdom
Roger M Francis, Musculoskeletal unit, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom
Nick P Thompson, Department of Medicine, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom
Author contributions: All authors contributed equally to the work.
Supported by the Dunhill Trust, National Osteoporosis Society and National Association of Colitis and Crohn’s disease
Correspondence to: Dr. Nick Thompson, MD, FRCP, Department of Medicine, Freeman Hospital, Newcastle-upon-Tyne, NE7 7DN, United Kingdom. nick.thompson@nuth.nhs.uk
Telephone: +44-191-2336161 Fax: +44-191-2231249
Received: March 20, 2006
Revised: March 24, 2006
Accepted: March 27, 2006
Published online: September 21, 2006
Abstract

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 the bone 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.

Keywords: Crohn’s disease; Osteoporosis; Osteopenia; Bone mineral density