Effect of mineral status and glucocorticoid use on bone mineral density in patients with Crohn's disease

Nutrition. 2018 Apr:48:13-17. doi: 10.1016/j.nut.2017.10.016. Epub 2017 Nov 27.

Abstract

Objectives: Crohn's disease (CD) is a condition that is characterized by chronic inflammation. The presence of multifactorial pathogenesis that results from inflammation is associated with low micronutrient consumption and glucocorticoid use, which may be related to bone health. This study aimed to evaluate the relationship between dietary mineral intake and glucocorticoid use in bone mineral density (BMD) in patients with CD.

Methods: A cross-sectional study of 62 patients with CD ages 20 y to 40 y measured their macro- and micronutrient intake with a 3-d food record. The lumbar spine and femoral neck BMDs were determined using a bone densitometry technique. The C-reactive protein (CRP) levels and erythrocyte sedimentation rate (ESR) values were also noted.

Results: Dietary intake of calcium, zinc, and magnesium was below the reference values but the phosphorus intake level was within the normal value range. Patients with osteopenia and osteoporosis accounted for 17.7% and 14.5%, respectively, of the total number of participants. Significant bone loss was found in 22.6% of patients taking glucocorticoid medications. BMD was significantly reduced and also observed in patients in the active phase of their disease. Zinc and calcium intakes were found to be correlated with reduced femoral neck BMD. The mean CRP and ESR values were above the normal ranges. Significant differences in age and ESR were observed between patients with normal and reduced BMD (P <0.05).

Conclusions: Low calcium and zinc intake, glucocorticoid use, and active disease phase are favorable conditions for bone loss in patients with Crohn's disease.

Keywords: Bone mass; Crohn's disease; Food consumption; Glucocorticoids; Nutrients.

MeSH terms

  • Adolescent
  • Adult
  • Bone Density / drug effects*
  • Bone Diseases, Metabolic / chemically induced*
  • Crohn Disease / complications
  • Crohn Disease / drug therapy*
  • Crohn Disease / physiopathology
  • Cross-Sectional Studies
  • Diet Surveys
  • Female
  • Femur Neck / physiopathology
  • Glucocorticoids / adverse effects*
  • Humans
  • Lumbar Vertebrae / physiopathology
  • Male
  • Micronutrients / analysis
  • Minerals / analysis
  • Nutritional Status
  • Osteoporosis / chemically induced*
  • Risk Factors
  • Severity of Illness Index
  • Young Adult

Substances

  • Glucocorticoids
  • Micronutrients
  • Minerals