Features of changes in bone mineral density in young patients with inflammatory bowel diseases

Introduction. Inflammatory bowel diseases (IBD) including Crohn's disease (CD) and ulcerative colitis (UC) are chronic relapsing conditions with gastrointestinal mucosa injuries and potential local and systemic complications. The incidence of osteoporosis (OP) in patients with IBD is very variable according to data from different studies. Aim. To evaluate changes in bone mineral density (BMD) and bone remodelling parameters in young patients with IBD for early detection of changes in the bone tissue. Materials and methods. The study included 123 patients with verified diagnoses of UC (n = 70) and CD (n = 53), who were observed at the State Autonomous Healthcare Institution Republican Clinical Hospital of the Ministry of Health of the Republic of Tatarstan from March 2023 to December 2024. All patients underwent a detailed clinical history and physical examination. Bone metabolism and its regulators such as osteocalcin (ng/ml), Beta-Cross Laps (ng/ml), P1NP (ng/ml), and vitamin D levels (ng/ml) were assessed. All patients underwent measurements of BMD using dual-energy X-ray absorptiometry to detect OP. Results. Of 123 young patients with IBD, 13.8% (17 patients) had bone mass below age-matched reference values based on dual-energy X-ray absorptiometry findings. Bone remodelling parameters assessment revealed changes in 31% (39 patients), and decrease in vitamin D levels in all patients of the study. Conclusions. Of 123 young patients with IBD examined, 13.8% (17) of patients had bone mass below age-matched reference values. The bone remodelling parameters were changed in a larger percentage of patients (31%). All patients with IBD had low vitamin D levels. The presence of moderate and severe IBD, low body mass index, systemic glucocorticoids in the IBD treatment protocol, as well as acute course of UC and presence of ileocolitis in CD significantly contribute to the decrease in Z-scores, and accordingly, the decrease in BMD.