RESEARCH ARTICLE
Bone Mineral Density and Bone Remodeling in Tunisian Patients with Inflammatory Bowel Disease
Samar Ben Jemaa1, *, Lassaad Chtourou2, Rim Akrout1, Khansa Chaabouni3, Tarek Chaabouni3, Hela Makni Fourati1, Ali Amouri2, Nabil Tahri2, Fatma Ayedi3, Sofien Baklouti1
Article Information
Identifiers and Pagination:
Year: 2019Volume: 13
First Page: 22
Last Page: 29
Publisher ID: TORJ-13-22
DOI: 10.2174/1874312901913010022
Article History:
Received Date: 30/11/2018Revision Received Date: 31/01/2019
Acceptance Date: 18/02/2019
Electronic publication date: 28/02/2019
Collection year: 2019
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract
Background:
A high prevalence of osteopenia and osteoporosis is observed in patients with Inflammatory Bowel Disease (IBD).
Objective:
The aim of our study was to investigate the prevalence of bone loss, bone remodeling and risk factors in Tunisian patient with IBD.
Patients and Methods:
The study included 40 patients with IBD and 32 age- and sex-matched healthy controls subjects. All participants underwent bone densitometry by dual energy X-ray absorptiometry at the femoral neck and lumbar spine. Serum levels of 25-hydroxy vitamin D (25(OH)D), parathyroid hormone (PTH), osteocalcin(OC), and urinary degradation products of C-terminal telopeptide of type I collagen (CTXI) were measured in all participants to assess the bone metabolism status.
Results:
Twelve (30%) patients were normal, 32.5% were osteopenic and 37.5% were osteoporotic. Osteoporosis was more frequent in IBD patients than controls (p=0.0001). Age and inflammation were associated with low bone mineral density (BMD). Mean calcium, phosphorus and alkaline phosphatase levels were similar in both groups. Median 25(OH) D levels were significantly lower in IBD patients compared with controls (p=0.0001). Median urinary CTXI levels were significantly higher in IBD patients compared with healthy controls (p=0.007). No significant differences between IBD patients and controls concerning the median serum OC and PTH levels were found.
Conclusion:
In our study, there is a high prevalence of low BMD in IBD patients and an increase in bone resorption without a change of bone formation. Low BMI and hypovitaminoses D were identified as risk factors for low BMD.
