High-resolution Quantitative Computed Tomography Demonstrates Structural Defects in Cortical and Trabecular Bone in IBD Patients

• Published in: Journal of Crohn's and colitis Vol. 10; no. 5; pp. 532 - 540
• Main Authors: Haschka, Judith, Hirschmann, Simon, Kleyer, Arnd, Englbrecht, Matthias, Faustini, Francesca, Simon, David, Figueiredo, Camille P., Schuster, Louis, Muschitz, Christian, Kocijan, Roland, Resch, Heinrich, Atreya, Raja, Rech, Jürgen, Neurath, Markus F., Schett, Georg
• Format: Journal Article
• Language: English
• Published: UK Oxford University Press 01.05.2016
• Subjects: Adult; Cancellous Bone - diagnostic imaging; Cancellous Bone - pathology; Case-Control Studies; Colitis, Ulcerative - complications; Colitis, Ulcerative - pathology; Cortical Bone - diagnostic imaging; Cortical Bone - pathology; Crohn Disease - complications; Crohn Disease - pathology; Cross-Sectional Studies; Female; Humans; Male; Middle Aged; Multivariate Analysis; Original; Osteoporosis - diagnostic imaging; Osteoporosis - etiology; Osteoporosis - pathology; Prospective Studies; Risk Factors; Tomography, X-Ray Computed - methods; computed tomography; osteoporosis; Inflammatory bowel disease; bone
• ISSN: 1873-9946; 1876-4479; 1876-4479
• DOI: 10.1093/ecco-jcc/jjw012

Background and Aims: 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. Conclusion: 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.