Increased Serum Bone Sialoprotein Concentrations in Patients with Crohn’s Disease

Zusammenfassung

Einleitung: Ein gestörter Kalziumhaushalt und/oder die systemische Gabe von Kortikosteroiden werden als mögliche Faktoren in Betracht gezogen, die zur Entstehung einer Osteopenie bei Patienten mit chronisch entzündlichen Darmerkrankungen führen können. Ebenso gibt es zunehmende Hinweise dafür, dass auch bestimmte pro-inflammatorische Zytokine direkt den Knochenstoffwechsel dieser Patienten beeinflussen können. Die Routineuntersuchungen zur Bestimmung der Knochenmasse sowie des Knochenabbaus umfassen üblicherweise osteodensitometrische Verfahren und u. a. die Bestimmung sogenannter Crosslinks im Serum und Urin. Neuere Studien zeigen jedoch zwischenzeitlich auf, dass Serum Bone Sialoprotein ein spezifischer Marker des Knochenstoffwechsels zu sein scheint.

Patienten und Methoden: Wir untersuchten 47 Patienten mit gesicherten chronisch entzündlichen Darmerkrankungen (Morbus Crohn n = 41, Colitis ulcerosa n = 6) sowie 17 gesunde und freiwillige Probanden, um Bone-Sialoprotein-Serumspiegel sowie andere Routineparameter des Knochenstoffwechsels bestimmen zu können.

Ergebnisse: Im Vergleich zur Kontrollgruppe fand sich nur bei Patienten mit Morbus Crohn eine signifikante Erhöhung der Bone Sialoproteinspiegel sowie der Crosslinks im Urin. Die übrigen Marker des Knochenstoffwechsels (z. B. alkalische Phosphatase, carboxyterminales Propeptid des Typ-I-Prokollagens, Desoxypyridinolin im Urin, Vitamin D, Serumphosphat und Serumkalzium) differierten im Vergleich zur Kontrollgruppe nicht signifikant.

Zusammenfassung: Aufgrund der vorgestellten Daten scheinen erhöhte Serum-Bone-Sialoproteinspiegel ein verlässlicher und sensitiver Parameter zu sein, der bei Patienten mit Morbus Crohn einen vermehrten Knochenabbau anzeigt.

Abstract

Introduction: Impaired calcium homeostasis and/or the administration of corticosteroids are considered to be among the factors contributing to the pathogenesis of osteopenia in patients with inflammatory bowel disease. There is an increasing evidence suggesting that certain pro-inflammatory cytokines may also directly influence the bone metabolism in these patients. Routine measurement of bone mass and loss usually include dual energy X-ray absorptiometry as well as urinary and serum assessment of collagen crosslinks. More recent studies include likewise the detection of bone sialoprotein into a specific diagnostics of bone turnover.

Patients and methods: We investigated 47 patients with inflammatory bowel disease (Crohn’s disease N = 41, ulcerative colitis N = 6) and 17 healthy volunteers to assess and compare serum levels of bone sialoprotein and other routine parameters of bone turnover. Bone sialoprotein levels were measured by using a ­recently described radioimmunoassay.

Results: In comparison to the control group, bone sialoprotein and urinary crosslinks were significantly increased only in patients with Crohn’s disease, while other markers of bone turnover (e. g. alkaline phosphatase, carboxylterminal propeptide of typ I procollagen, urinary deoxypyridinoline, vitamin D, phosphate and calcium) did not differ significantly between the patients’ groups.

Conclusion: According to these data, increased serum bone sialoprotein concentrations seem to be an additional valuable and sensitve marker of bone resorption in patients with Crohn’s disease.

Schlüsselwörter

Morbus Crohn - Bone Sialoprotein - Osteopenie

Key words

Bone sialoprotein - Crohn’s disease - osteopenia

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