Bone Mineral Density and Bone Remodeling in Tunisian Patients with Inflammatory Bowel Disease



Samar Ben Jemaa1, *, Lassaad Chtourou2, Rim Akrout1, Khansa Chaabouni3, Tarek Chaabouni3, Hela Makni Fourati1, Ali Amouri2, Nabil Tahri2, Fatma Ayedi3, Sofien Baklouti1
1 Department of Rhumatology, Hedi Chaker University Hospital, Sfax, PC: 3089, Tunisia
2 Department of Gastroenterology and Hepatology, Hedi Chaker University Hospital, Sfax, Tunisia
3 Laboratory of Biochemistry, Habib Bourguiba University Hospital, Sfax, Tunisia

Abstract

Background:

A high prevalence of osteopenia and osteoporosis is observed in patients with inflammatory bowel disease (IBD).

Objective:

The aim of our study was to investigate the prevalence of bone loss, bone remodeling and risk factors in Tunisian patient with IBD.

Patients and Methods:

The study included 40 patients with IBD and 32 age- and sex-matched healthy controls subjects. All participants underwent bone densitometry by dual energy X-ray absorptiometry at the femoral neck and lumbar spine. Serum levels of 25-hydroxy vitamin D (25(OH)D), parathyroid hormone (PTH), osteocalcin(OC), and urinary degradation products of C-terminal telopeptide of type I collagen (CTXI) were measured in all participants to assess the bone metabolism status.

Results:

Twelve (30%) patients were normal, 32.5% were osteopenic and 37.5% were osteoporotic. Osteoporosis was more frequent in IBD patients than controls (p=0.0001). Age and inflammation were associated with low bone mineral density (BMD). Mean calcium, phosphorus and alkaline phosphatase levels were similar in both groups. Median 25(OH) D levels were significantly lower in IBD patients compared with controls (p=0.0001). Median urinary CTXI levels were significantly higher in IBD patients compared with healthy controls (p=0.007). No significant differences between IBD patients and controls concerning the median serum OC and PTH levels were found.

Conclusion:

In our study, there is a high prevalence of low BMD in IBD patients and an increase in bone resorption without a change of bone formation. Low BMI and hypovitaminoses D were identified as risk factors for low BMD.

Keywords: Inflammatory bowel disease, Osteopenia, Osteoporosis, Hypovitaminosis D, Bone mineral density, Bone remodeling.


Abstract Information


Identifiers and Pagination:

Year: 2018
Volume: 12
Publisher Item Identifier: EA-TOTJ-2018-20

Article History:

Received Date: 27/6/2018
Revision Received Date: 31/10/2018
Acceptance Date: 23/11/2018
Electronic publication date: 5/12/2018
Collection year: 2018

© 2018 Ben Jemaa et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Correspondence: Address correspondence to this author at the Department of Rhumatology, Hedi Chaker University Hospital, Sfax, PC: 3089, Tunisia; Tel: 23733004; E-mail: bendjmaa@gmail.com