Oshima Toshihiro, Taira Satoru, Nonaka Masaya, Hayama Yoshiki, Yagi Kenji, Yukawa Ikuko, Koh Mari, Kondo Mari, Kawakami Kohei, Kawai Takashi, Miyaoka Masaaki, Sakai Yoshihiro, Moriyasu Fuminori, Matauoka Hiroaki, Yamamoto Kengo
Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan.
Hepatogastroenterology. 2008 Nov-Dec;55(88):2116-20.
Decreased bone mineral density is a complication to which we should always pay attention in the treatment of Crohn's disease (CD). However, there is still no clear consensus with regard to evaluation methods and the appropriate observation period for its detection. In the present study, we measured the bone mineral density of 30 CD patients who were treated at the outpatient clinic of our institution and investigated its relationship with various clinical characteristics including sex, age, duration of illness, history of enterectomy, total steroid consumption, body weight, and body mass index (BMI) and with bone metabolism markers. A decreased bone mineral density was detected in 9 patients (30%). The bone mineral density did not correlate with total steroid consumption, but showed a negative correlation with the Crohn's disease activity index (CDAI).When bone metabolism markers were investigated, the bone mineral density showed a negative correlation with Glu-osteocalcin (Glu-OC) and serum type I collagen cross-linked N-telopeptide (NTx) in patients with a low bone mineral density. Based on these results, the decrease of bone mineral density in CD patients was considered to the underlying disease itself. Therefore, control of disease activity is very important in CD patients, and periodic measurement of bone mineral density in combination with bone mineral markers (Glu-OC and serum NTx) may be useful for predicting a decrease of bone mineral density.
