TY - JOUR
T1 - Longitudinal monitoring of bone measured by quantitative multisite ultrasound in patients with Crohn's disease
AU - Zadik, Zvi
AU - Sinai, Tali
AU - Zung, Amnon
AU - Reifen, Ram
PY - 2005/2
Y1 - 2005/2
N2 - Background: Crohn's disease (CD) is characterized, among other features, by intestinal malabsorption of minerals, vitamins, and various food ingredients. This may cause a suboptimal peak bone mass and thereby susceptibility to osteoporosis at an early age. Objective: Longitudinal measurement of bone in CD during active disease and during remission. Design: We evaluated 24 patients with CD (16 males) 14 to 16 years of age longitudinally, every 3 months over 12 months, for disease activity. Longitudinal follow-up by quantitative ultrasound measurement using a bone sonometer (Sunlight Omnisense, Tel Aviv, Israel) that obtains axial speed of sound (SOS) was also performed. Eight of the CD patients were in remission (R-CD), characterized by accelerated weight and height gain and near-normal erythrocyte sedimentation rate and serum iron. Eight patients had active CD (A-CD), and 8 patients were under treatment with oxandrolone. Results: By two-way repeated-measures analysis of variance, the change in SOS Z-score of tibia at 0, 6, and 12 months was as follows: -0.5 ± 0.2 to -0.3 ± 0.2, -0.6 ± 0.2 to -1.0 ± 0.5 and -0.6 ± 0.2 to -0.4 ± 0.2 in the remission, active disease, and oxandrolone-treated groups, respectively (P < 0.001). Similarly, the change in SOS Z-score of radius during the study was as follows: -0.5 ± 0.3 to -0.6 ± 0.3, -0.6 ± 0.3 to -1.0 ± 0.3 and -0.6 ± 0.2 to -0.4 ± 0.2 in the remission, active disease, and oxandrolone-treated groups, respectively (P < 0.001). While a small change over time in patients in remission was noted, SOS decreased in patients with active disease and increased in oxandrolone-treated patients. Despite the fact that SOS remained in the normative range in all patients, a clear deterioration was demonstrated for patients with active disease. Conclusions: We conclude that longitudinal follow-up of patients with active disease may detect an early pattern of deterioration in quality of bone.
AB - Background: Crohn's disease (CD) is characterized, among other features, by intestinal malabsorption of minerals, vitamins, and various food ingredients. This may cause a suboptimal peak bone mass and thereby susceptibility to osteoporosis at an early age. Objective: Longitudinal measurement of bone in CD during active disease and during remission. Design: We evaluated 24 patients with CD (16 males) 14 to 16 years of age longitudinally, every 3 months over 12 months, for disease activity. Longitudinal follow-up by quantitative ultrasound measurement using a bone sonometer (Sunlight Omnisense, Tel Aviv, Israel) that obtains axial speed of sound (SOS) was also performed. Eight of the CD patients were in remission (R-CD), characterized by accelerated weight and height gain and near-normal erythrocyte sedimentation rate and serum iron. Eight patients had active CD (A-CD), and 8 patients were under treatment with oxandrolone. Results: By two-way repeated-measures analysis of variance, the change in SOS Z-score of tibia at 0, 6, and 12 months was as follows: -0.5 ± 0.2 to -0.3 ± 0.2, -0.6 ± 0.2 to -1.0 ± 0.5 and -0.6 ± 0.2 to -0.4 ± 0.2 in the remission, active disease, and oxandrolone-treated groups, respectively (P < 0.001). Similarly, the change in SOS Z-score of radius during the study was as follows: -0.5 ± 0.3 to -0.6 ± 0.3, -0.6 ± 0.3 to -1.0 ± 0.3 and -0.6 ± 0.2 to -0.4 ± 0.2 in the remission, active disease, and oxandrolone-treated groups, respectively (P < 0.001). While a small change over time in patients in remission was noted, SOS decreased in patients with active disease and increased in oxandrolone-treated patients. Despite the fact that SOS remained in the normative range in all patients, a clear deterioration was demonstrated for patients with active disease. Conclusions: We conclude that longitudinal follow-up of patients with active disease may detect an early pattern of deterioration in quality of bone.
KW - Bone density
KW - Crohn's disease
KW - Oxandrolone
UR - http://www.scopus.com/inward/record.url?scp=12344277992&partnerID=8YFLogxK
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C2 - 15681906
AN - SCOPUS:12344277992
SN - 0192-0790
VL - 39
SP - 120
EP - 123
JO - Journal of Clinical Gastroenterology
JF - Journal of Clinical Gastroenterology
IS - 2
ER -