title: Bone assessment in patients with ileal pouch-anal anastomosis for inflammatory bowel disease.
abstract: BACKGROUND
  Patients with ulcerative colitis are at risk of low bone mineral density (BMD). Proctocolectomy with ileal pouch-anal anastomosis (IPAA) for ulcerative colitis diminishes the risk of bone disease. The aims of this study were to assess the mechanism of low BMD and to measure bone density changes after IPAA.
  
  
  METHODS
  Twenty patients with IPAA for ulcerative colitis, of mean(s.d.) age 38(9) (range 21-58) years, had measurements of lumbar spine and femoral neck BMD by dual energy X-ray absorptiometry, a mean(s.d.) 28(23) (range 3-84) months after proctocolectomy. Serum levels of calcium, phosphate, parathyroid hormone, osteocalcin and 25-hydroxy vitamin D were determined. Fifteen patients were followed for 28(12) (range 8-50) months.
  
  
  RESULTS
  At baseline, six patients had spine BMD more than two standard deviations below the normal value, and three had vertebral crush fractures. Mean vitamin D values were normal and no patient had osteomalacia. BMD increased with time elapsed since IPAA (spine: r = 0.71, P = 0.005). During follow-up, mean(s.d.) changes in bone density were +2.3(3.8) and +2.1(5.6) per cent per year at the spine and femoral neck respectively.
  
  
  CONCLUSIONS
  These results suggest that in patients with IPAA for ulcerative colitis, low BMD is not associated with vitamin D malabsorption and may be reversible after surgery.
authors.affiliation: Service d'Hépato-Gastroentérologie, Hôpital Cochin, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Abitbol
authors.forename: C
authors.initials: C
authors.lastname: Roux
authors.forename: S
authors.initials: S
authors.lastname: Guillemant
authors.forename: P
authors.initials: P
authors.lastname: Valleur
authors.forename: P
authors.initials: P
authors.lastname: Hautefeuille
authors.forename: M
authors.initials: M
authors.lastname: Dougados
authors.forename: D
authors.initials: D
authors.lastname: Couturier
authors.forename: S
authors.initials: S
authors.lastname: Chaussade
mesh_terms: D000328:Adult; D015519:Bone Density; D003093:Colitis, Ulcerative / Q000503:physiopathology* / Q000601:surgery*; D005260:Female; D005598:Fractures, Spontaneous / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016737:Proctocolectomy, Restorative; D011446:Prospective Studies; D011859:Radiography