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Increased bone resorption in patients with Crohn's disease
R J Robinson1, S J Iqbal, K Abrams
1Gastrointestinal Research Unit, Leicester General Hospital, UK.
Alimentary Pharmacology & Therapeutics
|September 3, 1998
Summary
Patients with Crohn's disease exhibit increased bone resorption, indicated by elevated urinary deoxypyridinoline (DPD). This suggests increased bone collagen degradation contributes to osteoporosis in these patients, potentially benefiting from anti-resorptive treatments.
Area of Science:
- Gastroenterology
- Endocrinology
- Bone Metabolism
Background:
- Crohn's disease (CD) patients face heightened risks of osteoporosis and fractures.
- The exact mechanisms driving bone loss in CD are not fully understood.
- Optimal therapeutic strategies for bone loss in CD remain undetermined.
Purpose of the Study:
- To investigate the mechanisms of bone loss in Crohn's disease.
- To assess bone turnover using biochemical markers in CD patients.
Main Methods:
- Dual-energy X-ray absorptiometry (DXA) measured bone mineral density in 117 CD patients.
- Serum osteocalcin (BGP), pro-collagen carboxy-terminal propeptide (PICP), bone-specific alkaline phosphatase (BALP), and urinary deoxypyridinoline (DPD) assessed bone turnover.
- Results were compared to 28 age-matched healthy controls.
Main Results:
- 41% of CD patients had reduced bone mineral density (z-score < -1).
- Bone formation markers (BGP, BALP, PICP) were within normal ranges and not significantly different from controls.
- Urinary DPD levels, a marker of bone resorption, were significantly higher in CD patients (P = 0.00001), with 63% showing elevated levels compared to UK reference ranges.
Conclusions:
- Increased bone resorption, evidenced by elevated urinary DPD, is common in Crohn's disease patients.
- Elevated DPD suggests increased bone collagen degradation contributes to osteoporosis in CD.
- Anti-resorptive agents, like bisphosphonates, may be effective treatments for osteoporosis in Crohn's disease.