Compston J E, Judd D, Crawley E O, Evans W D, Evans C, Church H A, Reid E M, Rhodes J
Gut. 1987 Apr;28(4):410-5. doi: 10.1136/gut.28.4.410.
Bone mineral content in spinal trabecular and peripheral cortical bone was measured in 75 unselected patients with small and/or large intestinal inflammatory bowel disease. Osteoporosis, defined as a bone mineral content greater than 2 SD below the age and sex matched normal mean value was present in 23 patients (30.6%). Three amenorrhoeic females aged 34, 38, and 42 years had severe clinical osteoporosis and a further three patients had one or more vertebral crush fractures. Eighteen of the 23 patients with osteoporosis had small intestinal disease with one or more resections and the mean lifetime steroid dose in those with osteoporosis was significantly higher than in those with normal bone mineral content. Bone mineral content in spinal trabecular bone showed significant negative correlations with lifetime steroid dose and serum alkaline phosphatase and a significant positive correlation with serum albumin. Peripheral cortical bone mineral content was positively correlated with body weight, height and body mass index. We conclude that the prevalence of osteoporosis is increased in patients with inflammatory bowel disease, severe clinical osteoporosis developing in some relatively young patients. The pathogenesis of this bone loss is probably multifactorial; steroid therapy is likely to be an important contributory factor.
对75例未经过挑选的患有小肠和/或大肠炎性肠病的患者测量了脊柱小梁骨和外周皮质骨的骨矿物质含量。骨质疏松症定义为骨矿物质含量比年龄和性别匹配的正常平均值低2个标准差以上，23例患者（30.6%）存在骨质疏松症。3名分别为34岁、38岁和42岁的闭经女性患有严重的临床骨质疏松症，另有3名患者有一处或多处椎体压缩性骨折。23例骨质疏松症患者中有18例患有小肠疾病且接受过一次或多次切除术，骨质疏松症患者的平均终生类固醇剂量显著高于骨矿物质含量正常的患者。脊柱小梁骨的骨矿物质含量与终生类固醇剂量和血清碱性磷酸酶呈显著负相关，与血清白蛋白呈显著正相关。外周皮质骨矿物质含量与体重、身高和体重指数呈正相关。我们得出结论，炎性肠病患者骨质疏松症的患病率增加，一些相对年轻的患者会发生严重的临床骨质疏松症。这种骨质流失的发病机制可能是多因素的；类固醇治疗可能是一个重要的促成因素。
