Metabolic bone disease in patients with inflammatory bowel diseases

• Grant number: 11/23152-5
• Support Opportunities: Regular Research Grants
• Duration: May 01, 2012 - April 30, 2014
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Luiz Ernesto de Almeida Troncon
• Grantee: Luiz Ernesto de Almeida Troncon
• Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil

Abstract

Patients with inflammatory bowel diseases (IBD) have increased risk of metabolic bone disease - osteopenia and osteoporosis. Calcium intestinal absorption may be impaired in IBD contributing to reduced bone mineral density (BMD). Measurement of vertebral bone marrow fat using magnetic resonance spectroscopy adds to standard dual energy X-ray absorptiometry and improves the assessment of bone strength, which, once decreased, may cause overt or subclinical fracture. The influence of reduced calcium intestinal absorption in BMD is unclear, as studies in IBD are scarce and the roles of inflammation and disease activity have not been much studied. Bone marrow fat concentration has been shown to relate to BMD and predict metabolic bone diseases in several conditions, but this relationship has not yet been determined in IBD. This study therefore aims at determining subclinical vertebral fracture, bone marrow fat concentration and calcium intestinal absorption in IBD. Patients with Cohn's disease (CD) or ulcerative colitis (UC), as well as patients with miscellaneous, non inflammatory conditions (diseased controls) and healthy controls will undergo a standard dual energy X-ray absorptiometry study including a morphometric assessment of vertebral bodies for determining BMD and subclinical fracture. Both magnetic resonance spectroscopy for determining vertebral bone marrow fat and the calcium intestinal absorption test will be performed in CD and UC patients and healthy controls only. It is expected that results will contribute to reassess the prevalence of bone disease and fracture in IBD, as well to shed light in the pathogenesis of this condition. (AU)