Journal of Crohn's and Colitis Advance Access published January 27, 2016 Manuscript Doi : 10.1093/ecco-jcc/jjw012
High-resolution quantitative computed tomography demonstrates structural defects in cortical and trabecular bone
ip t
in IBD patients Judith Haschka1,3, Simon Hirschmann2, Arnd Kleyer1, Matthias Englbrecht1, Francesca
cr
Faustini1, David Simon1, Camille P Figueiredo1,4, Louis Schuster1, Christian Muschitz3,
Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany,
an
1
Department of Internal Medicine 1, University of Erlangen-Nuremberg, Erlangen, Germany,
3
St. Vincent Hospital, Medical Department 2, The VINFORCE Study Group, Academic
M
2
Teaching Hospital of Medical University of Vienna, Austria; 4Division of Rheumatology,
ed
Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
pt
Short title: Bone Loss in IBD patients
Ac ce
Disclosures: Nothing to disclose. Word Count: 3439
Correspondence to: Georg Schett, MD; Department of Internal Medicine 3, University of Erlangen-Nuremberg, Ulmenweg 18, 91054 Erlangen, Germany, Tel. +49.9131.85.39131, [email protected]; Simon Hirschmann, MD; Department of Internal Medicine 1,
University of Erlangen-Nuremberg, Ulmenweg 18, 91054 Erlangen, Germany, Tel. +49.9131.85.39131, [email protected]
Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: [email protected]
Downloaded from http://ecco-jcc.oxfordjournals.org/ by guest on February 22, 2016
Schett1
us
Roland Kocijan3, Heinrich Resch3, Raja Atreya2, Jürgen Rech1, Markus F. Neurath2,Georg
Manuscript Doi : 10.1093/ecco-jcc/jjw012
Abstract Background and AimsTo investigate the macro- and microstructural changes of bone in patients with inflammatory bowel disease (IBD) and to define the factors associated with bone
ip t
loss in IBD Methods A total of148 subjects, 59 with Crohn’s Disease (CD), 39 with Ulcerative Colitis
cr
(UC) and 50 healthy controls were assessed for the geometric, volumetric and microstructural
addition, demographic and disease-specific characteristics of IBD patients were recorded.
an
Results IBD patients and controls were comparable in age, sex and body mass index. Total (p=0.001), cortical (p 5mg equivalent to prednisolone daily ≥ 3 months) were
M
common in the cohort: 28.6% of IBD patients received 0 to 3 pulse therapies (group I), 21.4% 4 to 10 pulses (group II) and 50% of patients had previous high exposures with more than 10
ed
pulses or continuous treatment > 1 year (group III). Serum C-reactive protein level was slightly elevated in both disease cohorts. The percentage
pt
of patients with substitution of calcium and 25(OH)-vitamin D3 was similar between CD and
Ac ce
UC. Consecutively, median serum vitamin D level was in the normal range in IBD patients, but with a broad range with low levels in patients without substitution (mean± SD, 29.6 ± 23.5 ng/mL). Low trauma fractures occurred in 7.1% of IBD patients. All fractures were selfreported peripheral and vertebral fractures. Only 5.1% of the patients were on current or prior anti-resorptive treatment with bisphosphonates.
Downloaded from http://ecco-jcc.oxfordjournals.org/ by guest on February 22, 2016
us
patients had an ileoanal pouch. Biological therapy was common in the study population
Manuscript Doi : 10.1093/ecco-jcc/jjw012
Volumetric Bone Mineral Density and Microstructure in IBD patients In the first part of the analysis we compared patients with IBD to healthy controls. Total volumetric BMD was significantly different in IBD patients and healthy controls with lower
ip t
values in IBD patients[IBD vs. controls: 299 (251;335) vs.326 (302;368)mgHA/cm³, p= 0.001]. Significant bone loss was found in both, cortical bone [811 (771;851)vs. 868
us
results on bone parameters are summarized in Table 2.
Geometrical analysis of cortical bone revealed a significant difference in cortical area [IBD
an
vs. controls: 54 (45;62)vs. 59 (54;75) mm2; p=0.001]. A similar pattern was found with
respect to cortical thickness [730 (595;815) and 830 (760;930) µm, p
High-resolution quantitative computed tomography demonstrates structural defects in cortical and trabecular bone
ip t
in IBD patients Judith Haschka1,3, Simon Hirschmann2, Arnd Kleyer1, Matthias Englbrecht1, Francesca
cr
Faustini1, David Simon1, Camille P Figueiredo1,4, Louis Schuster1, Christian Muschitz3,
Department of Internal Medicine 3, University of Erlangen-Nuremberg, Erlangen, Germany,
an
1
Department of Internal Medicine 1, University of Erlangen-Nuremberg, Erlangen, Germany,
3
St. Vincent Hospital, Medical Department 2, The VINFORCE Study Group, Academic
M
2
Teaching Hospital of Medical University of Vienna, Austria; 4Division of Rheumatology,
ed
Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
pt
Short title: Bone Loss in IBD patients
Ac ce
Disclosures: Nothing to disclose. Word Count: 3439
Correspondence to: Georg Schett, MD; Department of Internal Medicine 3, University of Erlangen-Nuremberg, Ulmenweg 18, 91054 Erlangen, Germany, Tel. +49.9131.85.39131, [email protected]; Simon Hirschmann, MD; Department of Internal Medicine 1,
University of Erlangen-Nuremberg, Ulmenweg 18, 91054 Erlangen, Germany, Tel. +49.9131.85.39131, [email protected]
Copyright © 2016 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: [email protected]
Downloaded from http://ecco-jcc.oxfordjournals.org/ by guest on February 22, 2016
Schett1
us
Roland Kocijan3, Heinrich Resch3, Raja Atreya2, Jürgen Rech1, Markus F. Neurath2,Georg
Manuscript Doi : 10.1093/ecco-jcc/jjw012
Abstract Background and AimsTo investigate the macro- and microstructural changes of bone in patients with inflammatory bowel disease (IBD) and to define the factors associated with bone
ip t
loss in IBD Methods A total of148 subjects, 59 with Crohn’s Disease (CD), 39 with Ulcerative Colitis
cr
(UC) and 50 healthy controls were assessed for the geometric, volumetric and microstructural
addition, demographic and disease-specific characteristics of IBD patients were recorded.
an
Results IBD patients and controls were comparable in age, sex and body mass index. Total (p=0.001), cortical (p 5mg equivalent to prednisolone daily ≥ 3 months) were
M
common in the cohort: 28.6% of IBD patients received 0 to 3 pulse therapies (group I), 21.4% 4 to 10 pulses (group II) and 50% of patients had previous high exposures with more than 10
ed
pulses or continuous treatment > 1 year (group III). Serum C-reactive protein level was slightly elevated in both disease cohorts. The percentage
pt
of patients with substitution of calcium and 25(OH)-vitamin D3 was similar between CD and
Ac ce
UC. Consecutively, median serum vitamin D level was in the normal range in IBD patients, but with a broad range with low levels in patients without substitution (mean± SD, 29.6 ± 23.5 ng/mL). Low trauma fractures occurred in 7.1% of IBD patients. All fractures were selfreported peripheral and vertebral fractures. Only 5.1% of the patients were on current or prior anti-resorptive treatment with bisphosphonates.
Downloaded from http://ecco-jcc.oxfordjournals.org/ by guest on February 22, 2016
us
patients had an ileoanal pouch. Biological therapy was common in the study population
Manuscript Doi : 10.1093/ecco-jcc/jjw012
Volumetric Bone Mineral Density and Microstructure in IBD patients In the first part of the analysis we compared patients with IBD to healthy controls. Total volumetric BMD was significantly different in IBD patients and healthy controls with lower
ip t
values in IBD patients[IBD vs. controls: 299 (251;335) vs.326 (302;368)mgHA/cm³, p= 0.001]. Significant bone loss was found in both, cortical bone [811 (771;851)vs. 868
us
results on bone parameters are summarized in Table 2.
Geometrical analysis of cortical bone revealed a significant difference in cortical area [IBD
an
vs. controls: 54 (45;62)vs. 59 (54;75) mm2; p=0.001]. A similar pattern was found with
respect to cortical thickness [730 (595;815) and 830 (760;930) µm, p
