Alterations of bone microarchitecture in young patients with inflammatory bowel diseases are associated with fracture risk during growth

Details

Serval ID
serval:BIB_7391C972710D
Type
Inproceedings: an article in a conference proceedings.
Publication sub-type
Abstract (Abstract): shot summary in a article that contain essentials elements presented during a scientific conference, lecture or from a poster.
Collection
Publications
Title
Alterations of bone microarchitecture in young patients with inflammatory bowel diseases are associated with fracture risk during growth
Title of the conference
IOF World Congress on Osteoporosis and 10th European Congress on Clinical and Economic Aspects of Osteoporosis and Osteoarthritis
Author(s)
Ferrari S. L., Zawadinski S., Herrmann F., Chevalley T., Jullierat P., Ratib O., Michetti P., Rizzoli R.
Address
Florence, Italy, May 5-8, 2010
ISBN
0937-941X
Publication state
Published
Issued date
2010
Peer-reviewed
Oui
Volume
21
Series
Osteoporosis International
Pages
10-11
Language
english
Notes
Meeting Abstract
Abstract
Aims: Inflammatory bowel diseases (IBD) appearing during childhood and adolescence compromise peak bone mass acquisition and increase fracture risk. The structural determinants of bone fragility in IBD however remain unknown.
Methods: We investigated volumetric bone mineral density (vBMD), trabecular and cortical bone microstructure at distal radius and tibia by high-resolution pQCT (XtremeCT, Scanco, Switzerland), aBMD at distal radius, hip and spine and vertebral fracture assessment (VFA) by DXA in 107 young patients (mean age 22.8 yrs, range 12.2-33.7 yrs; 62 females and 45 males) with Crohn's disease (n=75), ulcerative colitis (n=25), undetermined
colitis (n=2), and no definitive diagnosis (n=5), and in 389 healthy young individuals.
Results: Mean disease duration was 6.1 yrs, 89/107 IBD patients received corticosteroids, 83 other immunomodulators, and 59 vitamin D. Clinical fractures were reported by 38 patients (mean age at 1st fracture, 12.6 yrs), the vast majority of the forearm, arm or hand; 5 had vertebral crush fractures (Grade 1 or 2) and 11 had
multiple fractures. As compared to healthy controls (matched 2:1 for age, sex, height and fracture history), the 102 patients with established IBD had similar weight but significantly lower aBMD at all sites, lower trabecular (Tb) BV/TV and number, and greater Tb separation and inhomogeneous Tb distribution (1/SD TbN) at both distal radius and tibia, lower tibia cortical thickness (CTh), but no differences in cortical vBMD nor bone perimeter. Among IBD's, aBMD was not associated with fractures (by logistic regression adjusted for age, age square, sex, height, weight and protein intake). However, radius and tibia Tb BV/TV, thickness and SD 1/TbN, as well as radius Tb separation and perimeter, were significantly associated with fracture risk (fully adjusted as above), whereas cortical vBMD and CTh were not. After adjustment for aBMD at radius, respectively at femur neck, radius SD 1/TbN and tibia BV/TV, TbTh and perimeter remained independently associated with fracture risk.
Conclusions: Young subjects with IBD have low bone mass and poor bone microarchitecture compared to healthy controls. Alterations of bone microarchitecture, particularly in the trabecular bone compartment, are specifically associated with increased fracture risk during growth.
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Create date
01/09/2010 10:00
Last modification date
03/03/2018 18:19
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