D.I. ABDULGANIEVA^1, 2, E.R. MYASOUTOVA², L.M. KUPKENOVA^1, 2, N.G. SHAMSUTDINOVA¹, A.KH. ODINTSOVA², L.R. SADYKOVA², N.A. CHEREMINA², A.R. YANGURAZOVA¹

¹Kazan State Medical Academy, Kazan

²Republic Clinical Hospital, Kazan

 Contact details:

Kupkenova L.M. — PhD (Medicine), post-graduate student of the Department of Hospital Therapy, therapist

Address: 49 Butlerov St., Kazan, Russian Federation, 420012, tel.: +7-917-901-14-98, e-mail: lkupkenova@mail.ru

Inflammatory bowel diseases (IBD) are characterized by the development of various systemic manifestations. One of the significant extraintestinal manifestations of IBD is a decrease in mineral density (BMD) (demineralization) of bone tissue and osteoporosis (OP). The pathogenesis of decreased BMD is multifactorial: the activity of immune inflammation of the gastrointestinal mucosa, medication intake, malnutrition (low calcium intake), decreased muscle and fat mass, vitamin D deficiency, as well as other factors contribute to the development of osteoporosis in such patients. Despite various studies examining the prevalence of decreased BMD in patients with IBD, data vary widely, ranging from 17 to 77%.

The purpose is to evaluate BMD, levels of bone resorption markers in young patients with IBD, and to evaluate the relationship between BMD and osteosynthesis markers.

Materials and methods. 62 patients with a verified diagnosis of IBD were examined: 30 patients had Crohn’s disease (CD), 32 patients had ulcerative colitis (UC). All patients underwent a general clinical examination, a double-absorption X-ray densitometric study with determination of BMD and bone mineral content (BMC), as well as determination of bone resorption parameters — osteocalcin, Beta-Crosslaps (C-terminal telopeptides of type I collagen) and marker determination formation of bone matrix P1NP. The level of the mineral part of bone mass was measured using the bioimpedance method on the ABC-02 «MEDASS» apparatus.

Results: Seven patients with IBD (11%) had low BMD for chronological age. The median values of BMD, osteocalcin, Beta-Crosslaps, and bone matrix formation marker P1NP in the general group of patients with IBD, as well as in the subgroups of patients with CD and UC are presented. A clinical example is presented.

Conclusion. Diagnosis of osteoporosis in patients with IBD is difficult for several reasons. It is important to assess the presence of risk factors in conjunction with laboratory and instrumental examinations.

Key words: inflammatory bowel diseases, Crohn’s disease, ulcerative colitis, osteoporosis.

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