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. 1988 Oct;29(10):1332–1336. doi: 10.1136/gut.29.10.1332

Increased rate of spinal trabecular bone loss in patients with inflammatory bowel disease.

R J Motley 1, E O Crawley 1, C Evans 1, J Rhodes 1, J E Compston 1
PMCID: PMC1433993  PMID: 3197979

Abstract

The rate of spinal trabecular bone loss during one year was measured in 54 patients with inflammatory bowel disease. The mean change in spinal bone mineral content was -5.1 mg/ml K2HPO4, representing 3% of the initial bone mineral content. The rate of bone loss showed a significant negative correlation with body mass index (r = -0.276, p less than 0.05) but no other significant correlations were found with other clinical or biochemical indices, including the total amount of prednisolone taken during the course of the study. Eleven patients had bone loss greater than 15 mg/ml/year; these included four non-steroid treated patients, two of whom had disease confined to the large bowel. The results indicate rapid rates of bone loss in some patients with inflammatory bowel disease over the course of one year. Although steroid therapy and malnutrition are likely to be contributory factors in some patients, other, as yet unidentified, risk factors also operate. The rapid bone loss observed in some patients emphasises the need for effective prophylactic regimes.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Adams P., Berridge F. R. Effects of kwashiorkor on cortical and trabecular bone. Arch Dis Child. 1969 Dec;44(238):705–709. doi: 10.1136/adc.44.238.705. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Aloia J. F., Vaswani A., Ellis K., Yuen K., Cohn S. H. A model for involutional bone loss. J Lab Clin Med. 1985 Dec;106(6):630–637. [PubMed] [Google Scholar]
  3. CURTISS P. H., Jr, CLARK W. S., HERNDON C. H. Vertebral fractures resulting from prolonged cortisone and corticotropin therapy. J Am Med Assoc. 1954 Oct 2;156(5):467–469. doi: 10.1001/jama.1954.02950050007002. [DOI] [PubMed] [Google Scholar]
  4. Cann C. E., Genant H. K., Kolb F. O., Ettinger B. Quantitative computed tomography for prediction of vertebral fracture risk. Bone. 1985;6(1):1–7. doi: 10.1016/8756-3282(85)90399-0. [DOI] [PubMed] [Google Scholar]
  5. Cann C. E., Genant H. K. Precise measurement of vertebral mineral content using computed tomography. J Comput Assist Tomogr. 1980 Aug;4(4):493–500. doi: 10.1097/00004728-198008000-00018. [DOI] [PubMed] [Google Scholar]
  6. Christiansen C., Rödbro P. Long-term reproducibility of bone mineral content measurements. Scand J Clin Lab Invest. 1977 Jun;37(4):321–323. doi: 10.3109/00365517709092636. [DOI] [PubMed] [Google Scholar]
  7. Compston J. E., Creamer B. Plasma levels and intestinal absorption of 25-hydroxyvitamin D in patients with small bowel resection. Gut. 1977 Mar;18(3):171–175. doi: 10.1136/gut.18.3.171. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Compston J. E., Judd D., Crawley E. O., Evans W. D., Evans C., Church H. A., Reid E. M., Rhodes J. Osteoporosis in patients with inflammatory bowel disease. Gut. 1987 Apr;28(4):410–415. doi: 10.1136/gut.28.4.410. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Genant H. K., Cann C. E., Ettinger B., Gordan G. S. Quantitative computed tomography of vertebral spongiosa: a sensitive method for detecting early bone loss after oophorectomy. Ann Intern Med. 1982 Nov;97(5):699–705. doi: 10.7326/0003-4819-97-5-699. [DOI] [PubMed] [Google Scholar]
  10. Genant H. K., Mall J. C., Wagonfeld J. B., Horst J. V., Lanzi L. H. Skeletal demineralization and growth retardation in inflammatory bowel disease. Invest Radiol. 1976 Nov-Dec;11(6):541–549. doi: 10.1097/00004424-197611000-00007. [DOI] [PubMed] [Google Scholar]
  11. Hahn T. J., Boisseau V. C., Avioli L. V. Effect of chronic corticosteroid administration on diaphyseal and metaphyseal bone mass. J Clin Endocrinol Metab. 1974 Aug;39(2):274–282. doi: 10.1210/jcem-39-2-274. [DOI] [PubMed] [Google Scholar]
  12. Harries A. D., Brown R., Heatley R. V., Williams L. A., Woodhead S., Rhodes J. Vitamin D status in Crohn's disease: association with nutrition and disease activity. Gut. 1985 Nov;26(11):1197–1203. doi: 10.1136/gut.26.11.1197. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Hendriksen C., Kreiner S., Binder V. Long term prognosis in ulcerative colitis--based on results from a regional patient group from the county of Copenhagen. Gut. 1985 Feb;26(2):158–163. doi: 10.1136/gut.26.2.158. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Hylander E., Ladefoged K., Madsen S. Calcium balance and bone mineral content following small-intestinal resection. Scand J Gastroenterol. 1981;16(2):167–176. doi: 10.3109/00365528109181952. [DOI] [PubMed] [Google Scholar]
  15. Krølner B., Pors Nielsen S. Bone mineral content of the lumbar spine in normal and osteoporotic women: cross-sectional and longitudinal studies. Clin Sci (Lond) 1982 Mar;62(3):329–336. doi: 10.1042/cs0620329. [DOI] [PubMed] [Google Scholar]
  16. Lindsay R., Hart D. M., Forrest C., Baird C. Prevention of spinal osteoporosis in oophorectomised women. Lancet. 1980 Nov 29;2(8205):1151–1154. doi: 10.1016/s0140-6736(80)92592-1. [DOI] [PubMed] [Google Scholar]
  17. NORDIN B. E. Effect of malabsorption syndrome on calcium metabolism. Proc R Soc Med. 1961 Jun;54:497–500. [PMC free article] [PubMed] [Google Scholar]
  18. Riggs B. L., Wahner H. W., Melton L. J., 3rd, Richelson L. S., Judd H. L., Offord K. P. Rates of bone loss in the appendicular and axial skeletons of women. Evidence of substantial vertebral bone loss before menopause. J Clin Invest. 1986 May;77(5):1487–1491. doi: 10.1172/JCI112462. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Ruegsegger P., Dambacher M. A., Ruegsegger E., Fischer J. A., Anliker M. Bone loss in premenopausal and postmenopausal women. A cross-sectional and longitudinal study using quantitative computed tomography. J Bone Joint Surg Am. 1984 Sep;66(7):1015–1023. [PubMed] [Google Scholar]
  20. SALVESEN H. A., BOE J. Osteomalacia in sprue. Acta Med Scand. 1953;146(4):290–299. doi: 10.1111/j.0954-6820.1953.tb10243.x. [DOI] [PubMed] [Google Scholar]
  21. Southgate D. A., Widdowson E. M., Smits B. J., Cooke W. T., Walker C. H., Mathers N. P. Absorption and excretion of calcium and fat by young infants. Lancet. 1969 Mar 8;1(7593):487–489. doi: 10.1016/s0140-6736(69)91589-x. [DOI] [PubMed] [Google Scholar]

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