Reduced bone mass and preserved marrow adipose tissue in patients with inflammatory bowel diseases in long-term remission
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Bone marrow adipose tissue has not been studied in patients with inactive inflammatory bowel disease. We found that these patients have preserved marrow adiposity even with low bone mass. Factors involved in bone loss in active disease may have long-lasting effects but do not seem to affect bone marrow adiposity.
Reduced bone mass is known to occur at varying prevalence in patients with inflammatory bowel diseases (IBD) because of inflammation, malnutrition, and steroid therapy. Osteoporosis may develop in these patients as the result of an imbalanced relationship between osteoblasts and adipocytes in bone marrow. This study aimed to evaluate for the first time bone mass and bone marrow adipose tissue (BMAT) in a particular subgroup of IBD patients characterized by long-term, steroid-free remission.
Patients with Crohn’s disease (CD; N = 21) and ulcerative colitis (UC; N = 15) and controls (C; N = 65) underwent dual X-ray energy absorptiometry and nuclear magnetic resonance spectroscopy of the L3 lumbar vertebra for BMAT assessment.
Both the CD and UC subgroups showed significantly higher proportions of patients than controls with Z-score ≤−2.0 at L1–L4 (C 1.54%; CD 19.05%; UC 20%; p = 0.02), but not at other sites. The proportions of CD patients with a T-score ˂−1.0 at the femoral neck (C 18.46%; CD 47.62%; p = 0.02) and total hip (C 16.92%; CD 42.86%; p = 0.03) were significantly higher than among controls. There were no statistically significant differences between IBD patients and controls regarding BMAT at L3 (C 28.62 ± 8.15%; CD 29.81 ± 6.90%; UC 27.35 ± 9.80%; p = 0.67).
IBD patients in long-term, steroid-free remission may have a low bone mass in spite of preserved BMAT. These findings confirm the heterogeneity of bone disorders in IBD and may indicate that factors involved in bone loss in active disease may have long-lasting effects on these patients.
KeywordsBone marrow adipose tissue Bone mass Crohn’s disease Inflammatory bowel diseases Ulcerative colitis
The authors are indebted to Marta T. Nakao and Rodrigo A. Pessini for their competent technical assistance.
Compliance with ethical standards
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional Ethics Committee (HCRP Case No. 3836/2011) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
This study was funded by Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP).
Conflicts of interest
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