Osteopenia with normal vitamin D metabolites after small-bowel resection for Crohn's disease.

Thirty-six unselected patients were investigated 3-24 years (mean, 7.8 years) after small-bowel resection for Crohn's disease (mean small intestinal resection, 105 cm). Iliac crest bone biopsies after in vivo tetracycline double-labelling showed a markedly reduced trabecular bone mass (controls, 0.25 +/- 0.06; patients, 0.15 +/- 0.05; p less than 0.01). The average bone remodeling and osteoid mineralization was normal, and only two patients demonstrated signs of frank but slight osteomalacia. The mean serum levels of the three vitamin D metabolites 25-hydroxyvitamin D, 24,25-dihydroxyvitamin D, and 1,25-dihydroxyvitamin D were normal. The observed reduction in trabecular bone mass may theoretically be followed by an increased risk of spontaneous fractures.

[1]  B. Isaksson,et al.  Effects of a low-fat diet on mineral absorption in small-bowel disease. , 1983, Scandinavian journal of gastroenterology.

[2]  P. Tothill,et al.  Total body calcium in rheumatoid arthritis: effects of disease activity and corticosteroid treatment. , 1982, British medical journal.

[3]  L. Mosekilde,et al.  Vitamin D metabolism and osteomalacia in patients with fractures of the proximal femur. , 1982, Acta orthopaedica Scandinavica.

[4]  L. Mosekilde,et al.  Serum levels of vitamin D metabolites and bone remodelling in hyperthyroidism. , 1982, Metabolism: clinical and experimental.

[5]  E. Hylander,et al.  Calcium balance and bone mineral content following small-intestinal resection. , 1981, Scandinavian journal of gastroenterology.

[6]  E. Hylander,et al.  Nitrogen absorption following small-intestinal resection. , 1980, Scandinavian journal of gastroenterology.

[7]  L. Mosekilde,et al.  Low serum levels of 1.25-dihydroxyvitamin D and histomorphometric evidence of osteomalacia after jejunoileal bypass for obesity. , 1980, Gut.

[8]  O. H. Sørensen,et al.  Measurement of circulating 1,25-dihydroxyvitamin D in man. Changes in serum concentrations during treatment with 1 alpha-hydroxycholecalciferol. , 1979, Acta endocrinologica.

[9]  O. H. Sørensen,et al.  Measurement of 25-hydroxyvitamin D in serum and its relation to sunshine, age and vitamin D intake in the Danish population. , 1979, Scandinavian journal of clinical and laboratory investigation.

[10]  M. Chapuy,et al.  Histomorphometric profile, pathophysiology and reversibility of corticosteroid-induced osteoporosis , 1979 .

[11]  J. Gazet,et al.  BONE DISEASE AFTER JEJUNO-ILEAL BYPASS FOR OBESITY , 1978, The Lancet.

[12]  B. Creamer,et al.  OSTEOMALACIA AFTER SMALL-INTESTINAL RESECTION , 1978, The Lancet.

[13]  B. Creamer,et al.  Plasma levels and intestinal absorption of 25-hydroxyvitamin D in patients with small bowel resection. , 1977, Gut.

[14]  Parfitt Am.  The actions of parathyroid hormone on bone: relation to bone remodeling and turnover, calcium homeostasis, and metabolic bone diseases. II. PTH and bone cells: bone turnover and plasma calcium regulation. , 1976 .

[15]  C. D. Janney,et al.  Calcium absorption in Crohn's disease. , 1976, Gastroenterology.

[16]  E. Longton,et al.  Frequency of osteomalacia and osteoporosis in fractures of the proximal femur. , 1974, Lancet.

[17]  G. Thompson,et al.  Absorption of vitamin D3-3H in control subjects and patients with intestinal malabsorption. , 1966, The Journal of clinical investigation.

[18]  D. Mollin,et al.  NUTRITIONAL PROBLEMS ASSOCIATED WITH EXTENSIVE LESIONS OF THE DISTAL SMALL INTESTINE IN MAN. , 1964, The Quarterly journal of medicine.