Ludwig Boltzmann-Institute of Osteology at Hanusch-Hospital of WGKK & Trauma Centre Meidling of AUVA, 1st Medical Department, Hanusch-Hospital, Vienna, Austria.
Ludwig Boltzmann-Institute of Osteology at Hanusch-Hospital of WGKK & Trauma Centre Meidling of AUVA, 1st Medical Department, Hanusch-Hospital, Vienna, Austria.
Bone. 2017 Dec;105:50-56. doi: 10.1016/j.bone.2017.07.011. Epub 2017 Jul 10.
Inflammatory bowel disease (IBD) affects many organ systems including the skeleton. In children with IBD, bone mineral density (BMD) and bone turnover are frequently low. Disturbances in bone mineralization density distribution (BMDD) are linked to alterations in bone material strength; however, BMDD has not previously been reported in children with chronic inflammatory disorders. The aim of this study was to characterize BMDD based on quantitative backscatter electron imaging in cancellous (Cn.) and cortical (Ct.) compartments from trans-iliac biopsy samples from a cohort of 20 treatment-naïve children at the time of their IBD diagnosis (12 males, mean age 14.5±2.3years). The outcomes were compared to pediatric reference BMDD data and correlation with revisited biochemical and histomorphometric outcomes was analyzed. BMDD in treatment-naïve children with IBD was shifted toward higher calcium concentrations compared to reference: (i) In cancellous bone, the most frequent calcium concentration (Cn.CaPeak+2.8%, p=0.004) and the portion of highly mineralized bone (Cn.CaHigh+52%, p=0.009) were increased. (ii) In cortical bone, the mineralization heterogeneity (Ct.CaWidth+17.0%, p=0.001) and Ct.CaHigh (+30.4%, p=0.006) were increased. (iii) Furthermore, significant correlations with serum alkaline phosphatase (ALP), bone-specific alkaline phosphatase (bsALP), and urinary crosslinked N-telopeptide of type I collagen (uNTX) were observed: the higher CaMean (the average calcium concentration), CaPeak and CaHigh, the lower were ALP, bsALP, and uNTX (p-value from <0.001 to 0.05). Children with treatment-naïve IBD have decreased bone turnover leading to a higher bone matrix mineralization density, findings which may contribute to compromised bone strength.
炎症性肠病（IBD）影响许多器官系统，包括骨骼。患有 IBD 的儿童骨密度（BMD）和骨转换通常较低。骨矿物质密度分布（BMDD）的紊乱与骨材料强度的改变有关；然而，以前没有报道过患有慢性炎症性疾病的儿童的 BMDD。本研究的目的是通过定量背散射电子成像来描述来自 20 名未经治疗的儿童的髂骨活检样本的 BMDD，这些儿童在 IBD 诊断时（12 名男性，平均年龄 14.5±2.3 岁）处于治疗前状态。将结果与儿科参考 BMDD 数据进行比较，并分析与重新评估的生化和组织形态计量学结果的相关性。与参考数据相比，未经治疗的 IBD 儿童的 BMDD 向更高的钙浓度偏移：（i）在松质骨中，最常见的钙浓度（Cn.CaPeak+2.8%，p=0.004）和高度矿化骨的比例（Cn.CaHigh+52%，p=0.009）增加。（ii）在皮质骨中，矿物质异质性（Ct.CaWidth+17.0%，p=0.001）和 Ct.CaHigh（+30.4%，p=0.006）增加。（iii）此外，与血清碱性磷酸酶（ALP）、骨特异性碱性磷酸酶（bsALP）和尿型胶原交联 N 末端肽（uNTX）显著相关：CaMean（平均钙浓度）、CaPeak 和 CaHigh 越高，ALP、bsALP 和 uNTX 越低（p 值从<0.001 到 0.05）。未经治疗的 IBD 儿童的骨转换减少导致更高的骨基质矿化密度，这些发现可能导致骨强度受损。
