MedWire News: Bone loss in patients with quiescent Crohn's disease (CD) is caused by reduced bone formation that may be a consequence of decreased osteocyte viability in the past, report researchers.
"CD is associated with an increased prevalence of osteoporosis, but the pathogenesis of this bone loss is only partly understood," note Nathalie Bravenboer (VU University Medical Center, Amsterdam, The Netherlands) and colleagues.
In this study, published in the journal Gastroenterology, Bravenboer and team recruited 23 patients with quiescent CD, aged 40.5 years on average, to gain a better understanding of bone biology in patients with inflammatory bowel disease.
The researchers explain that only patients with quiescent CD were included to try and reduce heterogeneity caused by active disease.
Transiliac bone biopsy samples were taken from the participants and histomorphometric analysis was performed. Age- and gender-matched controls without CD were also tested for comparison purposes.
Trabecular bone volume was significantly lower in patients with CD than controls, at 18.90% versus 25.49%. CD patients also had significantly decreased trabecular thickness compared with controls, at 120.61 versus 151.42 µm. They also had a lower mineral apposition rate, an indicator of bone formation and resorption, at 0.671 versus 0.746 µm/d for controls.
In trabecular bone of patients with CD, osteocyte density and apoptosis were normal but the percentage of empty lacunae among patients was higher than that of published values in controls.
"This finding may be explained by an increased osteocyte apoptosis in the past, as empty lacunae mark sites were osteocytes have died previously," remark Bravenboer et al.
Of note, the reduction in bone mass was more marked in men than in women with CD.
These results agree with those of previous studies showing reduced bone mineral density in patients with inflammatory bowel diseases compared with the general population, as reported by Medwire News.
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