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Background: Crohn’ s disease (CD) is characterized, among other features, by intestinal malabsorption of miner als, 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 remissi on. Design: We evaluated 24 patients with CD (16 males) 14 to 16 years of age lo ngitudinally, every 3 months over 12 months, for disease activity. Longitudinal follow- up by quantitative ultrasound measurement using a bone sonometer (Sunli ght Omnisense, Tel Aviv, Israel) that obtains axial speed of sound (SOS) was als o performed. Eight of the CD patients were in remission (R- CD), characterized by accelerated weight and height gain and near- normal erythrocyte sedimentatio n 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 ana lysis of variance, the change in SOS Z- score of tibia at 0, 6, and 12 months w as 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 oxa ndrolone- treated groups, respectively (P < 0.001). Similarly, the change in SO S 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 i n 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- tre ated patients. Despite the fact that SOS remained in the normative range in all patients, a clear deterioration was demonstrated for patients with active diseas e. Conclusions: We conclude that longitudinal follow- up of patients with activ e disease may detect an early pattern of deterioration in quality of bone.
Background: Crohn’s disease (CD) is characterized, among other features, by intestinal malabsorption of miner als, 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 remissi on. Design: We evaluated 24 patients with CD (16 males) 14 to 16 years of age lo ngitudinally, every 3 months over 12 months, for disease activity. Longitudinal follow-up by quantitative ultrasound measurement using a bone sonometer (Sunli ght Omnisense, Tel Aviv, Israel) that gains axial speed of sound (SOS) was als performed. Eight of the CD patients were in remission (R-CD) Eight patients had active CD (A-CD), and 8 patients were under treatment with oxandrolone. Results: By two- way repeated- measures an analysis of var iance, the change in SOS Z-score of tibia at 0, 6, and 12 months w 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 oxa ndrolone-treated groups, respectively (P <0.001). Similarly, the change in SO S 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-tre ated patients. Despite the fact that SOS remained in the normative range in all patients, a clear deterioration was demonstrated for patients with active diseas e. Conclusions : We conclude that longitudinal follow-up of patients with activ e disease may detect an early pattern of deterioration in quality of bone.