High-resolution quantitative computed tomography demonstrates structural defects in cortical and trabecular bone in IBD patients

J Haschka, S Hirschmann, A Kleyer… - Journal of Crohn's …, 2016 - academic.oup.com
J Haschka, S Hirschmann, A Kleyer, M Englbrecht, F Faustini, D Simon, CP Figueiredo…
Journal of Crohn's and Colitis, 2016academic.oup.com
Abstract 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 …
Abstract
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.
Oxford University Press