Osteologie, Table of Contents

Osteologie 2009; 18(03): 209-216
DOI: 10.1055/s-0037-1619894

Original and review articles

Schattauer GmbH

Erythrocyte sedimentation rate as an osteoporosis risk factor in patients with active Crohn’s disease

Blutsenkungsgeschwindigkeit als ein Risikofaktor für Osteoporose in Patienten mit aktivem Morbus Crohn

H. Siggelkow

¹Department of Gastroenterology and Endocrinology, University Clinic of Goettingen, Goettingen, Germany

²Endokrinologikum Gö ttingen, Goettingen, Germany

,

J. Cortis

¹Department of Gastroenterology and Endocrinology, University Clinic of Goettingen, Goettingen, Germany

,

Ch. Claus

¹Department of Gastroenterology and Endocrinology, University Clinic of Goettingen, Goettingen, Germany

,

M. Funke

³Department of Radiology, University Clinic of Gö ttingen, Goettingen, Germany

,

W. Nolte

¹Department of Gastroenterology and Endocrinology, University Clinic of Goettingen, Goettingen, Germany

,

M. Hü fner

¹Department of Gastroenterology and Endocrinology, University Clinic of Goettingen, Goettingen, Germany

,

D. Raddatz

¹Department of Gastroenterology and Endocrinology, University Clinic of Goettingen, Goettingen, Germany

› Author Affiliations

Summary

Crohn’s disease (CD) is associated with reduced bone mineral density and increased fracture risk. To assess the effects of the inflammatory process itself on bone parameters, we investigated patients with active CD and in remission without glucocorticoid treatment four weeks prior to analysis. Patients with active CD were compared to age-and sex-matched healthy volunteers and osteoporosis patients. Bone mineral density, bone formation and resorption markers were assessed, in addition to simple inflammatory markers and cytokines. Out of seven patients with active disease, three had osteopenia and one osteoporosis (WHO definition). The erythrocyte sedimentation rate (ESR) was associated with BMD at the femoral neck (R² = 0.853, p < 0.01) and the spine (R² = 0.772, p < 0.05). ESR seems to influence bone formation, as shown by lower bone alkaline phosphatase with high ESR (R² = 0.725, R = – 0.852, p < 0.05). The clinical disease activity score was not useful in determining patients’ risk of acquiring bone disease. In conclusion, in patients with Crohn’s disease, the degree of the inflammatory process as assessed by ESR indicates bone loss and might be of value in identifying patients at risk of developing osteoporosis.

Zusammenfassung

Bei Patienten mit Morbus Crohn (MC) besteht hä ufig eine erniedrigte Knochendichte (BMD) und ein erhö htes Risiko fü r Frakturen. In dieser Studie untersuchten wir Patienten im akuten Schub eines MC und in Remission ohne Steroidtherapie vier Wochen vor der Untersuchung hinsichtlich Knochenstoffwechsel, Knochendichte, Entzü ndungsmarkern sowie Zykotinen. Als Vergleich dienten alters-und geschlechtsadaptierte gesunde Probanden sowie Osteoporosepatienten. Von sieben Patienten mit akutem Schub des MC hatten vier eine Osteopenie oder Osteoporose nach WHO-Kriterien. Die Blutsenkung (BSG) war mit der BMD am Femurhals (R² = 0.853, p < 0.01) und an der Wirbelsä ule assoziiert (R² = 0.772, p < 0.05). Die BSG korrelierte weiterhin negativ zur Knochenformation gemessen an der knochenspezifischen alkalischen Phosphatase (R² = 0.725, R = – 0.852, p < 0.05). Der klinische Aktivitä tsindex CDAI war nicht in der Lage, das Risiko fü r die Knochenbeteiligung vorherzusagen. Bei Patienten mit MC scheint der Entzü ndungsprozess, charakterisiert durch die hohe BSG, Knochenverlust anzuzeigen und kann fü r die Bestimmung des Osteoporoserisikos bei MC-Patienten wertvoll sein.

Keywords

Keywords

Crohn’s disease - osteoporosis - risk factors - ESR

Schlüsselwörter

Schlüsselwörter

Morbus Crohn - Osteoporose - Risikofaktoren - Blutsenkungsgeschwindigkeit

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