Bone assessment in patients with ileal pouch-anal anastomosis for inflammatory bowel disease
Methods Twenty patients with IPAA for ulcerative colitis, of mean(s.d.) age 38(9) (range 21-58) years, had measurements of lumbar spine and femoral neck BMD by dual energy X-ray absorptiometry, a mean(s.d.) 28(23) (range 3-84) months after proctocolectomy. Serum levels of calcium, phosphate, parathyroid hormone, osteocalcin and 25-hydroxy vitamin D were determined. Fifteen patients were followed for 28(12) (range 8-50) months.
Results At baseline, six patients had spine BMD more than two standard deviations below the normal value, and three had vertebral crush fractures. Mean vitamin D values were normal and no patient had osteomalacia. BMD increased with time elapsed since IPAA (spine: r=0·71, P=0·005). During follow-up, mean(s.d.) changes in bone density were +2·3(3·8) and +2·1(5·6) per cent per year at the spine and femoral neck respectively.
Conclusion These results suggest that in patients with IPAA for ulcerative colitis, low BMD is not associated with vitamin D malabsorption and may be reversible after surgery.
Document Type: Research Article
Affiliations: 1: Service d'Hepato-Gastroenterologie 2: Clinique de Rhumatologie, Hopital Cochin 3: Laboratoire de Biochimie, Faculte de MedecinePitie-Salpetriere 4: Service de Chirurgie Digestive, Hopital Lariboisiere, Paris, France
Publication date: November 1, 1997