title: Longitudinal monitoring of bone measured by quantitative multisite ultrasound in patients with Crohn's disease.
abstract: BACKGROUND
  Crohn's disease (CD) is characterized, among other features, by intestinal malabsorption of minerals, vitamins, and various food ingredients. This may cause a suboptimal peak bone mass and thereby susceptibility to osteoporosis at an early age.
  
  
  OBJECTIVE
  Longitudinal measurement of bone in CD during active disease and during remission.
  
  
  METHODS
  We evaluated 24 patients with CD (16 males) 14 to 16 years of age longitudinally, every 3 months over 12 months, for disease activity. Longitudinal follow-up by quantitative ultrasound measurement using a bone sonometer (Sunlight Omnisense, Tel Aviv, Israel) that obtains axial speed of sound (SOS) was also performed. Eight of the CD patients were in remission (R-CD), characterized by accelerated weight and height gain and near-normal erythrocyte sedimentation rate and serum iron. Eight patients had active CD (A-CD), and 8 patients were under treatment with oxandrolone.
  
  
  RESULTS
  By two-way repeated-measures analysis of variance, the change in SOS Z-score of tibia at 0, 6, and 12 months was as follows: -0.5 +/- 0.2 to -0.3 +/- 0.2, -0.6 +/- 0.2 to -1.0 +/- 0.5 and -0.6 +/- 0.2 to -0.4 +/- 0.2 in the remission, active disease, and oxandrolone-treated groups, respectively (P < 0.001). Similarly, the change in SOS Z-score of radius during the study was as follows: -0.5 +/- 0.3 to -0.6 +/- 0.3, -0.6 +/- 0.3 to -1.0 +/- 0.3 and -0.6 +/- 0.2 to -0.4 +/- 0.2 in the remission, active disease, and oxandrolone-treated groups, respectively (P < 0.001). While a small change over time in patients in remission was noted, SOS decreased in patients with active disease and increased in oxandrolone-treated patients. Despite the fact that SOS remained in the normative range in all patients, a clear deterioration was demonstrated for patients with active disease.
  
  
  CONCLUSIONS
  We conclude that longitudinal follow-up of patients with active disease may detect an early pattern of deterioration in quality of bone.
authors.affiliation: Pediatric Endocrine Unit, Kaplan Medical Center, Hadassah Medical School, Jerusalem, Israel. zvizadik@012.net.il
authors.forename: Zvi
authors.initials: Z
authors.lastname: Zadik
authors.forename: Tali
authors.initials: T
authors.lastname: Sinai
authors.forename: Amnon
authors.initials: A
authors.lastname: Zung
authors.forename: Ram
authors.initials: R
authors.lastname: Reifen
mesh_terms: D000293:Adolescent; D045930:Anabolic Agents / Q000627:therapeutic use; D000704:Analysis of Variance; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010074:Oxandrolone / Q000627:therapeutic use; D011884:Radius / Q000000981:diagnostic imaging* / Q000378:metabolism; D015203:Reproducibility of Results; D013977:Tibia / Q000000981:diagnostic imaging* / Q000378:metabolism; D014463:Ultrasonography
chemical_list: D045930:Anabolic Agents; D010074:Oxandrolone