title: Increase in bone mineral density in strictly treated Crohn's disease patients with concomitant calcium and vitamin D supplementation.
abstract: OBJECTIVE
  Decreased bone mineral density (BMD) is common in Crohn's disease (CD) patients. This paper reports on the prevalence of decreased BMD in a referral cohort study of CD-patients next to the change of BMD over time in relation with CD-associated clinical characteristics.
  
  
  METHODS
  205 CD patients of a referral hospital were enrolled between January1998-January 2010 when measurement of BMD by dual X-ray absorptiometry (DXA) was available. Follow-up DXA scan was performed in subjects with known risk factors besides Crohn indicative for low BMD. Treatment of CD patients was according to a protocol which is comparable to the current (inter)national guidelines. In osteopenic patients, supplemental vitamin D (800 IU) and Calcium (500-1000 mg) were prescribed.
  
  
  RESULTS
  Mean BMD at baseline was 0.97 ± 0.16 gram/cm(2) in lumbar spine and 0.87 ± 0.12 gram/cm(2) in the total hip. At baseline, higher age and low Body Mass Index (BMI), were negatively correlated with BMD. Eighty-four patients underwent a second BMD assessment with a median interval period of 4 years (IQR 3-6). A mean annual increase of +0.76% (95%CI: -2.63%; +3.87%) in lumbar spine and +0.43% (95%CI: -2.65% ; +1.11%) in total hip was observed.
  
  
  CONCLUSIONS
  Higher age, male sex, low BMI, and a higher age at diagnosis of CD were associated with low BMD. Follow-up of BMD in CD patients showed a contraintuitive small increase of BMD at lumbar spine and total hip in CD patients only using supplemental vitamin D and calcium next to strict treatment of CD.
authors: Department of Gastroenterology and Hepatology, VU University Medical Centre, PO Box 7057, The Netherlands. sf.bakker1@vumc.nl
authors: Sjoerd F
authors: SF
authors: Bakker
authors: Vincent K
authors: VK
authors: Dik
authors: Birgit I
authors: BI
authors: Witte
authors: Paul
authors: P
authors: Lips
authors: Jan C
authors: JC
authors: Roos
authors: Adriaan A
authors: AA
authors: Van Bodegraven
mesh_terms: D015502:Absorptiometry, Photon; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000150:complications / Q000188:drug therapy*; D002118:Calcium / Q000627:therapeutic use*; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology*; D019587:Dietary Supplements; D005260:Female; D005500:Follow-Up Studies; D006615:Hip / Q000000981:diagnostic imaging; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014807:Vitamin D / Q000627:therapeutic use*
chemical_list: D000305:Adrenal Cortex Hormones; D014807:Vitamin D; D002118:Calcium