Cortés-Berdonces María, Arberas Beatriz, de la Fuente Marina, Thuissard Israel J, Marín Fernando
Department of Endocrinology, Hospital Universitario Ruber Juan Bravo, 28006 Madrid, Spain.
Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain.
J Clin Med. 2025 Jun 3;14(11):3933. doi: 10.3390/jcm14113933.
Most of the studies that have investigated bone quality in inflammatory bowel disease (IBD) have utilized dual-energy X-ray absorptiometry (DXA). We assessed the bone status of IBD adult patients using a comprehensive array of non-invasive techniques. Fifty IBD patients (30 women) and 50 healthy volunteers-matched for age, gender, and body mass index-were prospectively recruited. Areal bone mineral density (aBMD) at the anteroposterior and lateral spine and the proximal femur was measured by DXA, including vertebral fracture assessment (VFA). Trabecular bone score (TBS), calcaneal quantitative ultrasound (QUS), volumetric bone mineral density (vBMD), and cortical thickness were assessed in the proximal femur with 3D-DXA. A comprehensive laboratory panel of calcium metabolism and bone turnover markers was included. Twenty-nine and 21 patients were diagnosed with ulcerative colitis (UC) and Crohn's disease (CD), respectively. VFA identified vertebral fractures in two IBD patients and no controls. No statistically significant differences were observed in TBS, aBMD, and vBMD between IBD and healthy controls. After excluding one predefined outlier, broadband ultrasound attenuation (BUA) showed lower values in IBD vs. controls [103.6 ± 14.3 vs. 111.3 ± 19.5 ( = 0.033)]. QUS analysis revealed statistically lower values in the CD group compared to controls. We found a positive correlation between all the QUS parameters with aBMD and vBMD. In our study of IBD subjects, most of whom had mild or quiescent disease, we did not observe significant bone quality deterioration. QUS was the only technique that showed lower values in IBD patients, especially in CD.
大多数研究炎症性肠病（IBD）骨质量的研究都采用了双能X线吸收法（DXA）。我们使用一系列全面的非侵入性技术评估了IBD成年患者的骨骼状况。前瞻性招募了50名IBD患者（30名女性）和50名年龄、性别和体重指数相匹配的健康志愿者。通过DXA测量前后位和侧位脊柱以及股骨近端的面骨矿物质密度（aBMD），包括椎体骨折评估（VFA）。使用三维DXA评估股骨近端的小梁骨评分（TBS）、跟骨定量超声（QUS）、体积骨矿物质密度（vBMD）和皮质厚度。纳入了一组全面的钙代谢和骨转换标志物实验室检测项目。分别有29例和21例患者被诊断为溃疡性结肠炎（UC）和克罗恩病（CD）。VFA在两名IBD患者中发现了椎体骨折，而对照组未发现。IBD患者与健康对照组在TBS、aBMD和vBMD方面未观察到统计学上的显著差异。在排除一个预先定义的异常值后，宽带超声衰减（BUA）显示IBD患者的值低于对照组[103.6±14.3 vs. 111.3±19.5（P = 0.033）]。QUS分析显示CD组的值在统计学上低于对照组。我们发现所有QUS参数与aBMD和vBMD之间存在正相关。在我们对IBD受试者的研究中，大多数患者患有轻度或静止期疾病，我们未观察到明显的骨质量恶化。QUS是唯一在IBD患者中显示值较低的技术，尤其是在CD患者中。
