Low bone mineral density in Crohn's disease, but not in ulcerative colitis, at diagnosis.
OBJECTIVE
The pathogenesis of low bone mineral density in patients with inflammatory bowel disease is unclear, and the relevance of secondary osteopenic influences is controversial. Our aim was to study bone mineral density in newly diagnosed patients.


METHODS
Bone mineral density and biochemical parameters of bone metabolism were measured in 15 patients with Crohn's disease and 15 patients with ulcerative colitis, all of whom were newly diagnosed. Lumbar and forearm bone mineral densities were measured by dual energy x-ray absorptiometry, and Z scores were obtained by comparison with age- and sex-matched normal values. Twenty-three patients had repeat measurements 1 year later, and 20 had received systemic steroids.


RESULTS
At diagnosis, the mean Z score for patients with Crohn's disease (spine, -1.06 +/- 0.86; forearm, -1.04 +/- 0.86) was significantly lower than that for patients with ulcerative colitis (spine, -0.03 +/- 1.16; forearm, 0.11 +/- 1.24). Inflammatory activity, disease localization, body mass index, smoking habits, sex, physical activity, or biochemical parameters did not account for this difference. Spine and forearm Z scores were significantly correlated. Mean Z scores after 1 year were not significantly different from initial Z scores.


CONCLUSIONS
At diagnosis, low bone mineralization is a feature of Crohn's disease but not ulcerative colitis. Treatment with corticosteroids did not result in further bone loss in 1 year.
Ghosh
S
S
Gastrointestinal Unit, Western General Hospital, Edinburgh, Scotland.
Cowen
S
S
Hannan
W J
WJ
Ferguson
A
A
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D001842:Bone and Bones / Q000378:metabolism; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism*; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm; D006801:Humans; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D013131:Spine / Q000378:metabolism
D000305:Adrenal Cortex Hormones