High prevalence of morphometric vertebral deformities in patients with inflammatory bowel disease.
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.
Heijckmann
Anna Caroline
AC
Department of Internal Medicine, Division of Endocrinology, Hospital Bernhoven, Veghel, The Netherlands. caroline@heesen.eu
Huijberts
Maya S P
MS
Schoon
Erik J
EJ
Geusens
Piet
P
de Vries
Jolanda
J
Menheere
Paul P C A
PP
van der Veer
Eveline
E
Wolffenbuttel
Bruce H R
BH
Stockbrugger
Reinhold W
RW
Dumitrescu
Bianca
B
Nieuwenhuijzen Kruseman
Arie C
AC
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