title: High prevalence of morphometric vertebral deformities in patients with inflammatory bowel disease.
abstract: BACKGROUND
  Earlier studies have documented that the prevalence of decreased bone mineral density (BMD) is elevated in patients with inflammatory bowel disease. The objective of this study was to investigate the prevalence of vertebral deformities in inflammatory bowel disease patients and their relation with BMD and bone turnover.
  
  
  METHODS
  One hundred and nine patients with Crohn's disease (CD) and 72 with ulcerative colitis (UC) (age 44.5+/-14.2 years) were studied. BMD of the hip (by dual X-ray absorptiometry) was measured and a lateral single energy densitometry of the spine for assessment of vertebral deformities was performed. Serum markers of bone resorption (carboxy-terminal cross-linked telopeptide of type I collagen) and formation (procollagen type I amino-terminal propeptide) were measured, and determinants of prevalent vertebral deformities were assessed using logistic regression analysis.
  
  
  RESULTS
  Vertebral deformities were found in 25% of both CD and UC patients. Comparing patients with and without vertebral deformities, no significant difference was found between Z-scores and T-scores of BMD, or levels of serum carboxy-terminal cross-linked telopeptide of type I collagen and serum procollagen type I amino-terminal propeptide. Using logistic regression analysis the only determinant of any morphometric vertebral deformity was sex. The presence of multiple vertebral deformities was associated with older age and glucocorticoid use.
  
  
  CONCLUSIONS
  The prevalence of morphometric vertebral deformities is high in CD and UC. Male sex, but neither disease activity, bone turnover markers, clinical risk factors, nor BMD predicted their presence. The determinants for having more than one vertebral deformity were age and glucocorticoid use. This implies that in addition to screening for low BMD, morphometric assessment of vertebral deformities is warranted in CD and UC.
authors.affiliation: Department of Internal Medicine, Division of Endocrinology, Hospital Bernhoven, Veghel, The Netherlands. caroline@heesen.eu
authors.forename: Anna Caroline
authors.initials: AC
authors.lastname: Heijckmann
authors.forename: Maya S P
authors.initials: MS
authors.lastname: Huijberts
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Schoon
authors.forename: Piet
authors.initials: P
authors.lastname: Geusens
authors.forename: Jolanda
authors.initials: J
authors.lastname: de Vries
authors.forename: Paul P C A
authors.initials: PP
authors.lastname: Menheere
authors.forename: Eveline
authors.initials: E
authors.lastname: van der Veer
authors.forename: Bruce H R
authors.initials: BH
authors.lastname: Wolffenbuttel
authors.forename: Reinhold W
authors.initials: RW
authors.lastname: Stockbrugger
authors.forename: Bianca
authors.initials: B
authors.lastname: Dumitrescu
authors.forename: Arie C
authors.initials: AC
authors.lastname: Nieuwenhuijzen Kruseman
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000209:etiology / Q000503:physiopathology; D001862:Bone Resorption / Q000209:etiology / Q000503:physiopathology; D003093:Colitis, Ulcerative / Q000150:complications; D003424:Crohn Disease / Q000150:complications; D003430:Cross-Sectional Studies; D005260:Female; D006620:Hip Fractures / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D013121:Spinal Curvatures / Q000209:etiology / Q000503:physiopathology; D016103:Spinal Fractures / Q000209:etiology* / Q000503:physiopathology