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P119. Vitamin D status and bone mineral density in patients recently diagnosed with Crohn's disease

G. Dumitrescu1, O. Nedelciuc1, M. Badea1, M. Dranga1, C. Mihai1, C. Cijevschi Prelipcean1, 1University of Medicine and Pharmacy Gr. T. Popa, Center of Gastroenterology and Hepatology “St. Spiridon” Hospital, Iasi, Romania

Background

Introduction: Crohn's disease is associated with an increased prevalence of low bone mineral density. One of the risk factors for the low bone mineral density is the inadequate level of 25 OH vitamin D.

The aim of this study was to evaluate the bone mineral density and the level of 25 OH vitamin D in patients recently diagnosed with Crohn's disease (CD).

Methods

A prospective study was performed in The Center of Gastroenterology and Hepatology Iasi and included patients recently diagnosed with CD. We noted demographic and clinical data (age, sex, extent of lesions, the degree of disease activity and treatment). 25 OH vitamin D level was measured in all patients and dual-energy X-ray absorptiometry (DEXA) was performed at lumbar level and femoral neck.

Results

46 CD patients were included in the study. They had an average age of 41.72 years, were mostly men (54.3%) with an average evolution of the disease about 3.8 years (70% had an evolution <1.5 years or were recently diagnosed). Most patients had colonic involvement (45.7%) or ileo-colonic (37%); and in terms of disease activity: 26.1% were in clinical and biological remission, 30.4% had mild-moderate activity, 37% moderate-severe activity, and 6.5% severe activity. 45.7% patients required treatment with oral or intravenous corticosteroids for about 2–3 months. Based on the lumbar and femoral neck osteodensitometry: 13 patients (28.3%) had normal BMD, 26 (56.5%) osteopenia, and 7 patients (15.2%) osteoporosis. 25 OH vitamin D levels was insufficient (<30 ng/ml) for 43.47%, normal for 19.56% patients and 17 patients (36.95%) presented severe deficiency of 25 OH vitamin D (<20 ng/ml).

Conclusion

Decreased bone density occurs early after the diagnosis of Crohn's disease. Hypovitaminosis D is induced by large lesions located mainly in the jejunum and ileum and also by the inflammatory activity. Vitamin D deficiency and the use of corticosteroids represent important risk factors in the development of bone demineralization in patients recently diagnosed with Crohn's disease.