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High-resolution Quantitative Computed Tomography Demonstrates Structural Defects in Cortical and Trabecular Bone in IBD Patients

2016; Oxford University Press; Volume: 10; Issue: 5 Linguagem: Inglês

10.1093/ecco-jcc/jjw012

1876-4479

Judith Haschka, Simon Hirschmann, Arnd Kleyer, Matthias Englbrecht, Francesca Faustini, David Simón, Camille Pinto Figueiredo, Louis Schuster, Christian Muschitz, Roland Kocijan, Heinrich Resch, Raja Atreya, Jürgen Rech, Markus F. Neurath, Georg Schett,

Bone health and osteoporosis research

Background and Aims: To investigate the macro- and microstructural changes of bone in patients with inflammatory bowel disease [IBD] and to define the factors associated with bone loss in IBD. Methods: A total of 148 subjects, 59 with Crohn's disease [CD], 39 with ulcerative colitis [UC], and 50 healthy controls were assessed for the geometric, volumetric and microstructural properties of bone using high-resolution peripheral quantitative computed tomography. In addition, demographic and disease-specific characteristics of IBD patients were recorded. Results: IBD patients and controls were comparable in age, sex, and body mass index. Total [ p = 0.001], cortical [ p < 0.001], and trabecular volumetric bone mineral density [BMD] [ p = 0.03] were significantly reduced in IBD patients compared with healthy controls. Geometric and microstructural analysis revealed significantly lower cortical area [ p = 0.001] and cortical thickness [ p < 0.001] without differences in cortical porosity, pore volume, or pore diameter. CD showed a more severe bone phenotype than UC: cortical bone loss was observed in both diseases, but CD additionally showed profound trabecular bone loss with reduced trabecular BMD [p = 0.008], bone volume [ p = 0.008], and trabecular thickness [ p = 0.009]. Multivariate regression models identified the diagnosis of CD, female sex, lower body mass index, and the lack of remission as factors independently associated with bone loss in IBD. Conclusion: IBD patients develop significant cortical bone loss, impairing bone strength. Trabecular bone loss is limited to CD patients, who exhibit a more severe bone phenotype compared with UC patients.