Inflammatory Bowel Diseases Service, Gastroenterology Institute, Rambam Health Care Campus, Haifa 3109601, Israel.
The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 3109601, Israel.
Nutrients. 2024 Aug 23;16(17):2827. doi: 10.3390/nu16172827.
Osteoporosis prevalence is increased in Crohn's disease (CD). Its pathogenesis in these patients is incompletely understood.
To identify factors associated with decreased bone mineral density (BMD) status in CD patients on a time-line course.
A retrospective study was performed that followed CD patients who underwent at least two bone mineral density scans (DEXAs). Follow-up began one year prior to the first DEXA test and lasted at least one year after a second test. Possible correlations between baseline and follow-up variables and changes in BMD status were examined. Change in BMD was defined as a transition from one bone density category to another (normal vs. osteopenia vs. osteoporosis). Binary variables were assessed using the Cochrane-Armitage test. Categorical variables were assessed using the chi-squared test. A multivariate analysis was performed.
The study included 141 patients. At baseline, 33 patients (23.4%) had normal BMD, 75 (53.2%) had osteopenia, and 33 (23.4%) had osteoporosis. Patients with low BMD had a lower baseline BMI compared to those with normal BMD ( < 0.0001). After a median follow-up of 48 months (IQR 29-71), BMD status worsened in 19 (13.5%) patients, whereas in 95 (67.3%) and 27 (19.1%) patients, BMD remained unchanged or improved, respectively. On the multivariate analysis, elevated median CRP throughout follow-up (OR = 0.8, 95% CI: 0.68-0.93) and low baseline BMI (OR = 0.9, 95% CI: 0.83-0.98) were associated with a lack of BMD status improvement.
Persistently elevated CRP and low BMI are associated with a lack of improvement in BMD. These findings underscore the importance of effective inflammation control and nutritional support to maintain and improve bone health.
克罗恩病（CD）患者的骨质疏松症患病率增加。但其发病机制尚不完全清楚。
确定 CD 患者随时间推移骨密度（BMD）状态下降的相关因素。
进行了一项回顾性研究，对至少进行了两次骨密度扫描（DEXA）的 CD 患者进行随访。随访从第一次 DEXA 测试前一年开始，至少持续到第二次测试后一年。检查了基线和随访变量与 BMD 状态变化之间的可能相关性。BMD 变化定义为从一种骨密度类别转变为另一种（正常与骨量减少与骨质疏松症）。使用 Cochrane-Armitage 检验评估二项变量。使用卡方检验评估分类变量。进行了多变量分析。
该研究纳入了 141 例患者。基线时，33 例（23.4%）患者 BMD 正常，75 例（53.2%）患者骨量减少，33 例（23.4%）患者骨质疏松症。低 BMD 患者的基线 BMI 低于 BMD 正常患者（<0.0001）。在中位数为 48 个月（IQR 29-71）的随访后，19 例（13.5%）患者的 BMD 状态恶化，而 95 例（67.3%）和 27 例（19.1%）患者的 BMD 保持不变或改善。在多变量分析中，整个随访期间 CRP 中位数升高（OR=0.8，95%CI：0.68-0.93）和低基线 BMI（OR=0.9，95%CI：0.83-0.98）与 BMD 状态无改善相关。
持续升高的 CRP 和低 BMI 与 BMD 无改善相关。这些发现强调了有效控制炎症和营养支持以维持和改善骨骼健康的重要性。
