Laboratory and instrumental criteria and some mechanisms of osteopenic syndrome in case of inflammatory bowel diseases

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Аннотация

The incidence of inflammatory bowel diseases (IBD) is steadily increasing in human population, while they have a chronic, in some cases disabling clinical course, are accompanied by not only intestinal, but also extraintestinal symptoms that require timely diagnosis. One of these extraintestinal manifestations (EIMS) is osteopenic syndrome, the mechanisms of which in case of IBD require study.

The aim: to study laboratory and instrumental special characteristics and some mechanisms of osteopenic syndrome in case of IBD.

Material and methods. The study included 194 patients having IBD: 157 with ulcerative colitis and 37 with Crohn’s disease (CD). Osteopenic syndrome was verified by densitometry of the calcaneus and by biochemical parameters: serum concentrations of tartrate-resistant acid phosphatase, alkaline phosphatase, ionized calcium. Immunohistochemical study of colon biopsy specimens with morphometric analysis of quantitative density of CD3 – immunopositive colonocytes, optical density and relative expression area of immunopositive to fatty acid synthase (FAS) colonocytes were performed.

Results. Osteopenic syndrome was detected in 26 patients with ulcerative colitis (16.5%) and 12 patients with CD (32.4%). Osteopenia correlated with the duration of the history, peculiarities of the clinical course, severity of IBD attack, steroid dependence, the presence of other EIMS. Morphometric parameters of CD3-positive colonocytes of the epithelium and lamina propria of colon mucosa, relative area and optical density of expression of colonocytes immunopositive to FAS were determined. Correlations of morphometric parameters of these colonocytes with instrumental and laboratory osteopenia markers were identified.

Conclusion. Risk factors for osteopenic syndrome in IBD were clinical and anamnestic data, steroid dependence, and in case of CD – comorbidity with other EIMS (non-alcoholic fatty liver disease and cholelithiasis). Correlations were found between densitometric and biochemical characteristics of bone remodeling with the quantitative density of CD3-positive colonocytes and optical density and expression area of colonocytes immunopositive to fatty acid synthase.

Толық мәтін

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Авторлар туралы

Irina Kozlova

V.I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of Russia

Email: kozlova@inbox.ru
ORCID iD: 0000-0002-5056-4504
SPIN-код: 7995-5124

MD, Dr. Sci. (Medicine), professor, head of the Department of therapy, gastroenterology and pulmonology

Ресей, Saratov

Maria Kudishina

V.I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of Russia

Email: aleshechkina-mary@mail.ru
ORCID iD: 0000-0001-8361-3846
SPIN-код: 1634-4930

MD, PhD (Medicine), assistant professor of the Department of therapy, gastroenterology and pulmonology

Ресей, Saratov

Anna Bykova

V.I. Razumovsky Saratov State Medical University of the Ministry of Healthcare of Russia

Хат алмасуға жауапты Автор.
Email: Vulpesruber@yandex.ru
ORCID iD: 0000-0002-9421-5146
SPIN-код: 2473-3125

MD, PhD (Medicine), associate professor of the Department of therapy, gastroenterology and pulmonology

Ресей, Saratov

Darya Uris

S.M. Kirov Military Medical Academy of the Ministry of Defence of the Russian Federation

Email: darya.uris@mail.ru
ORCID iD: 0009-0000-5788-5346
SPIN-код: 4075-1592

MD, head of the office of endoscopy, endoscopist at the Department and clinic of infectious diseases (with a course in medical parasitology and tropical diseases)

Ресей, Saint Petersburg

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2. Fig. 1. Results of calcaneal densitometry in inflammatory bowel diseases in the patients included in the study

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3. Fig. 2. Micrographs of colon biopsies (authors I.M. Kvetnoy, Yu.S. Krylova)

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