P268. Chemerin, visfatin and vaspin levels in relation to fat mass and bone mineral density in IBD
S. Terzoudis, N. Malliaraki, I. Damilakis, I. Neratzoulakis, C. Georgousaki, V. Tzimourtos, E. Kouroumalis, I. Koutroubakis, University Hospital of Heraklion, Gastrenterology, Heraklion, Crete, Greece
It has been suggested that the bone and fat interface is implicated in the pathogenesis of osteoporosis. Several studies have shown a strong correlation between fat mass (FM) and bone mineral density (BMD) in patients with IBD but data including the action of adipokines on this association are rather limited. The aim of this study was to investigate the role of the adipokines chemerin, visfatin and vaspin in patients with ulcerative colitis (UC) and Crohn's Disease (CD) in relation to FM and BMD.
115 consecutive patients with IBD (67 CD and 48 UC) and 98 matched healthy controls (HC) were enrolled in this study. All patients underwent bone densitometry by dual energy x-ray absorptiometry at the femoral neck and lumbar spine, and evaluation of body mass composition with GE-Lunar Prodigy along with host software Encore. Chemerin, visfatin and vaspin serum levels were measured in IBD patients and HC using commercially available enzyme linked immunosorbent assays (ELISA). Patients were classified as normal (T-score >−1 SD at both lumbar spine and hip), osteopenic (T-score from −1.0 to −2.5SD at either lumbar spine or hip or both), and osteoporotic (T-score <−2.5 at either lumbar spine or hip or both).
Osteopenia was observed in 75 patients with IBD (65.2%, 59 CD and 26 UC) and osteoporosis in 23 patients (20%, 19 CD, 4 UC). Osteoporotic patients had a significant lower total fat mass (19501.3±8085.2 gr) than the osteopenic patients (23089.2±9939.9 gr) and the patients with normal BMD (28410±10692gr) (p = 0.01). Mean (±standard deviation) serum chemerin levels were 14.1±6.6 ng/ml in CD patients, 13.5±3.3 ng/ml in UC patients and 7.8±2.7 ng/ml in HC (P < 0.0001). No differences between males and females or between UC and CD were observed. Subgroup analysis of correlation of chemerin levels with clinical characteristics showed significant association only with indices of osteoporosis. Chemerin serum levels were found significantly correlated with T score both at the femoral neck and lumbar spine (r = 0.25 P = 0.007 and r = 0.19, P = 0.03 respectively). There was no significant correlation of chemerin levels with BMI, CRP and fat distribution. No significant correlations between visfatin or vaspin and any of the examined parameters (including disease type or characteristics, FM and BMD) were observed.
Fat mass seems to play an important role in the development of osteoporosis in IBD patients. Serum chemerin levels are significantly increased in patients with IBD compared to HC and significantly correlated with the development of osteoporosis.