Assessment of bone health by bone turnover biomarkers in a cohort of Egyptian patients with inflammatory bowel disease: a cross-sectional analytical study
Abstract Background Patients with inflammatory bowel disease (IBD) are at variable risk of reduced bone mineral density (BMD) and osteoporosis (OP) owing to glucocorticoids, chronic inflammation, malabsorption, etc. This makes them prone to osteoporotic fractures, which poorly affect the quality of...
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| Format: | Article |
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SpringerOpen
2025-06-01
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| Series: | Egyptian Rheumatology and Rehabilitation |
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| Online Access: | https://doi.org/10.1186/s43166-025-00332-6 |
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| author | Salma Omran Hadeel Gamal Eldeen Zeinab Abdellatif Doaa M. Abdou Reem Hamdy A Mohammed AbdelAziz Gaber Ahmed Farrag Maissa El Raziky |
| author_facet | Salma Omran Hadeel Gamal Eldeen Zeinab Abdellatif Doaa M. Abdou Reem Hamdy A Mohammed AbdelAziz Gaber Ahmed Farrag Maissa El Raziky |
| author_sort | Salma Omran |
| collection | DOAJ |
| description | Abstract Background Patients with inflammatory bowel disease (IBD) are at variable risk of reduced bone mineral density (BMD) and osteoporosis (OP) owing to glucocorticoids, chronic inflammation, malabsorption, etc. This makes them prone to osteoporotic fractures, which poorly affect the quality of life. Our purpose is to measure bone turnover markers (BTMs) reflecting bone resorption and formation, in addition to calciotropic hormones in IBD patients, and compare them to healthy controls and their relation to disease activity, extension, and treatment modalities. Results This is a cross-sectional analytical study that included 92 participants: 45 IBD patients; ulcerative colitis (UC) and Crohn’s disease (CD) and 47 controls. Fasting blood samples were withdrawn for BTMs including bone formation markers (Procollagen I N-terminal propeptide {PINP} and bone-specific alkaline phosphatase {BALP}) and bone resorptive marker (C-terminal telopeptide of type I collagen {CTX}) in addition to calciotropic hormones (25-hydroxyvitamin D {25(OH)D} and parathyroid hormones PTH}). These markers were evaluated in both UC and CD patients with respect to disease activity, extension, or treatment modality. Low serum 25(OH)D levels were detected in UC (92%) and CD (100%), whereas high PTH levels were detected in UC (48%) and CD (45%) with elevated median levels. No significant differences were identified between the UC and CD groups. IBD patients exhibited a significant increase in CTX, PINP, and BALP levels, indicating higher turnover and metabolic bone disease with no significant differences between UC and CD groups. Higher levels of BTMs were observed in cases with low vitamin D levels. Considering disease activity and bowel involvement, BTM levels were comparable in UC and CD patients. Patients receiving anti-tumor necrosis-α (anti-TNF-α), 17/45, had significantly lower increases in CTX and PINP levels. Conclusion Biochemical and hormonal work-up using BTMs, 25(OH)D, and PTH may be beneficial to assess early bone health in IBD patients. IBD patients with lower levels of vitamin D were more prone to higher BTMs and bone changes. However, IBD patients receiving anti-TNF-α were less prone to bone changes, denoting better bone integrity, than those not receiving anti-TNF-α. |
| format | Article |
| id | doaj-art-03c2d644a46147b5b6fa30dd4a7f702c |
| institution | OA Journals |
| issn | 2090-3235 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Egyptian Rheumatology and Rehabilitation |
| spelling | doaj-art-03c2d644a46147b5b6fa30dd4a7f702c2025-08-20T02:05:41ZengSpringerOpenEgyptian Rheumatology and Rehabilitation2090-32352025-06-0152111410.1186/s43166-025-00332-6Assessment of bone health by bone turnover biomarkers in a cohort of Egyptian patients with inflammatory bowel disease: a cross-sectional analytical studySalma Omran0Hadeel Gamal Eldeen1Zeinab Abdellatif2Doaa M. Abdou3Reem Hamdy A Mohammed4AbdelAziz Gaber5Ahmed Farrag6Maissa El Raziky7Endemic medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo UniversityEndemic medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo UniversityEndemic medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo UniversityClinical and Chemical pathology Department, Faculty of Medicine, Cairo UniversityIntegrated Clinical and Research Centre for Intestinal Disorders (ICRID), Faculty of Medicine, Cairo UniversityEndemic medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo UniversityEndemic medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo UniversityEndemic medicine and Hepato-gastroenterology Department, Faculty of Medicine, Cairo UniversityAbstract Background Patients with inflammatory bowel disease (IBD) are at variable risk of reduced bone mineral density (BMD) and osteoporosis (OP) owing to glucocorticoids, chronic inflammation, malabsorption, etc. This makes them prone to osteoporotic fractures, which poorly affect the quality of life. Our purpose is to measure bone turnover markers (BTMs) reflecting bone resorption and formation, in addition to calciotropic hormones in IBD patients, and compare them to healthy controls and their relation to disease activity, extension, and treatment modalities. Results This is a cross-sectional analytical study that included 92 participants: 45 IBD patients; ulcerative colitis (UC) and Crohn’s disease (CD) and 47 controls. Fasting blood samples were withdrawn for BTMs including bone formation markers (Procollagen I N-terminal propeptide {PINP} and bone-specific alkaline phosphatase {BALP}) and bone resorptive marker (C-terminal telopeptide of type I collagen {CTX}) in addition to calciotropic hormones (25-hydroxyvitamin D {25(OH)D} and parathyroid hormones PTH}). These markers were evaluated in both UC and CD patients with respect to disease activity, extension, or treatment modality. Low serum 25(OH)D levels were detected in UC (92%) and CD (100%), whereas high PTH levels were detected in UC (48%) and CD (45%) with elevated median levels. No significant differences were identified between the UC and CD groups. IBD patients exhibited a significant increase in CTX, PINP, and BALP levels, indicating higher turnover and metabolic bone disease with no significant differences between UC and CD groups. Higher levels of BTMs were observed in cases with low vitamin D levels. Considering disease activity and bowel involvement, BTM levels were comparable in UC and CD patients. Patients receiving anti-tumor necrosis-α (anti-TNF-α), 17/45, had significantly lower increases in CTX and PINP levels. Conclusion Biochemical and hormonal work-up using BTMs, 25(OH)D, and PTH may be beneficial to assess early bone health in IBD patients. IBD patients with lower levels of vitamin D were more prone to higher BTMs and bone changes. However, IBD patients receiving anti-TNF-α were less prone to bone changes, denoting better bone integrity, than those not receiving anti-TNF-α.https://doi.org/10.1186/s43166-025-00332-6Bone turnover markersInflammatory bowel diseaseVitamin D |
| spellingShingle | Salma Omran Hadeel Gamal Eldeen Zeinab Abdellatif Doaa M. Abdou Reem Hamdy A Mohammed AbdelAziz Gaber Ahmed Farrag Maissa El Raziky Assessment of bone health by bone turnover biomarkers in a cohort of Egyptian patients with inflammatory bowel disease: a cross-sectional analytical study Egyptian Rheumatology and Rehabilitation Bone turnover markers Inflammatory bowel disease Vitamin D |
| title | Assessment of bone health by bone turnover biomarkers in a cohort of Egyptian patients with inflammatory bowel disease: a cross-sectional analytical study |
| title_full | Assessment of bone health by bone turnover biomarkers in a cohort of Egyptian patients with inflammatory bowel disease: a cross-sectional analytical study |
| title_fullStr | Assessment of bone health by bone turnover biomarkers in a cohort of Egyptian patients with inflammatory bowel disease: a cross-sectional analytical study |
| title_full_unstemmed | Assessment of bone health by bone turnover biomarkers in a cohort of Egyptian patients with inflammatory bowel disease: a cross-sectional analytical study |
| title_short | Assessment of bone health by bone turnover biomarkers in a cohort of Egyptian patients with inflammatory bowel disease: a cross-sectional analytical study |
| title_sort | assessment of bone health by bone turnover biomarkers in a cohort of egyptian patients with inflammatory bowel disease a cross sectional analytical study |
| topic | Bone turnover markers Inflammatory bowel disease Vitamin D |
| url | https://doi.org/10.1186/s43166-025-00332-6 |
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