title: High-resolution Quantitative Computed Tomography Demonstrates Structural Defects in Cortical and Trabecular Bone in IBD Patients.
abstract: OBJECTIVE
  To investigate the macro- and microstructural changes of bone in patients with inflammatory bowel disease [IBD] and to define the factors associated with bone loss in IBD.
  
  
  METHODS
  A total of 148 subjects, 59 with Crohn's disease [CD], 39 with ulcerative colitis [UC], and 50 healthy controls were assessed for the geometric, volumetric and microstructural properties of bone using high-resolution peripheral quantitative computed tomography. In addition, demographic and disease-specific characteristics of IBD patients were recorded.
  
  
  RESULTS
  IBD patients and controls were comparable in age, sex, and body mass index. Total [p = 0.001], cortical [p < 0.001], and trabecular volumetric bone mineral density [BMD] [p = 0.03] were significantly reduced in IBD patients compared with healthy controls. Geometric and microstructural analysis revealed significantly lower cortical area [p = 0.001] and cortical thickness [p < 0.001] without differences in cortical porosity, pore volume, or pore diameter. CD showed a more severe bone phenotype than UC: cortical bone loss was observed in both diseases, but CD additionally showed profound trabecular bone loss with reduced trabecular BMD [p = 0.008], bone volume [p = 0.008], and trabecular thickness [p = 0.009]. Multivariate regression models identified the diagnosis of CD, female sex, lower body mass index, and the lack of remission as factors independently associated with bone loss in IBD.
  
  
  CONCLUSIONS
  IBD patients develop significant cortical bone loss, impairing bone strength. Trabecular bone loss is limited to CD patients, who exhibit a more severe bone phenotype compared with UC patients.
authors.affiliation: Department of Internal Medicine 3, St Vincent Hospital, VINFORCE Study Group, Medical University of Vienna, Vienna, Austria.
authors.forename: Judith
authors.initials: J
authors.lastname: Haschka
authors.affiliation: Department of Internal Medicine 1, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Simon
authors.initials: S
authors.lastname: Hirschmann
authors.affiliation: Department of Internal Medicine 3.
authors.forename: Arnd
authors.initials: A
authors.lastname: Kleyer
authors.affiliation: Department of Internal Medicine 3.
authors.forename: Matthias
authors.initials: M
authors.lastname: Englbrecht
authors.affiliation: Department of Internal Medicine 3.
authors.forename: Francesca
authors.initials: F
authors.lastname: Faustini
authors.affiliation: Department of Internal Medicine 3.
authors.forename: David
authors.initials: D
authors.lastname: Simon
authors.affiliation: Department of Internal Medicine 3, Division of Rheumatology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
authors.forename: Camille P
authors.initials: CP
authors.lastname: Figueiredo
authors.affiliation: Department of Internal Medicine 3.
authors.forename: Louis
authors.initials: L
authors.lastname: Schuster
authors.affiliation: St Vincent Hospital, VINFORCE Study Group, Medical University of Vienna, Vienna, Austria.
authors.forename: Christian
authors.initials: C
authors.lastname: Muschitz
authors.affiliation: St Vincent Hospital, VINFORCE Study Group, Medical University of Vienna, Vienna, Austria.
authors.forename: Roland
authors.initials: R
authors.lastname: Kocijan
authors.affiliation: St Vincent Hospital, VINFORCE Study Group, Medical University of Vienna, Vienna, Austria.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Resch
authors.affiliation: Department of Internal Medicine 1, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Raja
authors.initials: R
authors.lastname: Atreya
authors.affiliation: Department of Internal Medicine 3.
authors.forename: Jürgen
authors.initials: J
authors.lastname: Rech
authors.affiliation: Department of Internal Medicine 1, University of Erlangen-Nuremberg, Erlangen, Germany.
authors.forename: Markus F
authors.initials: MF
authors.lastname: Neurath
authors.affiliation: Department of Internal Medicine 3, georg.schett@uk-erlangen.de.
authors.forename: Georg
authors.initials: G
authors.lastname: Schett
mesh_terms: D000328:Adult; D000071556:Cancellous Bone / Q000000981:diagnostic imaging* / Q000473:pathology; D016022:Case-Control Studies; D003093:Colitis, Ulcerative / Q000150:complications* / Q000473:pathology; D000071538:Cortical Bone / Q000000981:diagnostic imaging* / Q000473:pathology; D003424:Crohn Disease / Q000150:complications* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000473:pathology; D011446:Prospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Inflammatory bowel disease; bone; computed tomography; osteoporosis
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