P293. Bone density and bone metabolism in patients with inflammatory bowel disease
G. Dumitrescu, I.A. Pintilie, O. Nedelciuc, A.M. Blaj, C. Mihai, C. Cijevschi Prelipcean, University of Medicine and Pharmacy Gr. T. Popa, Center of Gastroenterology and Hepatology “St. Spiridon” Hospital, Iasi, Romania
Patients with inflammatory bowel disease (IBD) are at high risk for low bone mineral density (BMD).
Aim: to evaluate BMD in IBD patients and its relationship with bone metabolism in a group of Romanian patients.
A prospective study was performed in The Center of Gastroenterology and Hepatology Iasi during April 2011-October 2012 and included IBD patients. The demographic data from the patients were noted. The bone density at lumbar and femoral neck level was determined for all patients using dual-energy X-ray absorbtiometry (DEXA). Serum levels of calcium, phosphate, alkaline phosphatase (ALP), and 25-hydroxyvitamin D (25-OH vitamin D) were measured to assess the bone metabolism status.
One hundred and eighty IBD patients were enrolled in the study. One hundred and thirty-four (74.44%) patients were identified as having ulcerative colitis (UC) and 46 (25.55%) as having Crohn's disease (CD). Based on the lumbar and femoral neck bone mass density: 65 (48.50%) UC patients and 26 (56.52%) CD patients were osteopenic, and 24 (17.91%) UC patients and 7 (15.21%) CD patients had osteoporosis. The average T scores from the femoral neck and lumbar spine in patients with UC were −1.54 and −1.88, and in patients with CD were −1.74 and −1.97, respectively (P > 0.05). The mean levels for calcium and ALP in UC and CD were in the normal range. The 25-OH vitamin D level was decreased in 92 UC patients (68.8%) and in 37 patients with CD patients (80.43%). No significant correlations were observed between BMD and the level of 25 OH vitamin D.
The high prevalence of low BMD in the Romanian population with IBD requires attention. The subclinical vitamin D deficiency may contribute to bone loss in IBD patients, which is more pronounced in patients with CD.