Déséquilibre du remodelage osseux chez des patients Tunisiens atteints de maladies inflammatoires chroniques de l’intestin
Mots-clés :
Remodelage osseux, maladies inflammatoires chroniques de l'intestin, ostéoporose, hypovitaminose DRésumé
Prérequis : La perte osseuse est une complication souvent ignorée au cours des maladies inflammatoires chroniques de l’intestin. Ses mécanismes ne sont pas totalement élucidés.But : Etudier le remodelage osseux chez les patients atteints de maladies inflammatoires chroniques de l’intestin. méthodes: Les produits de dégradation urinaire des télopeptides Cterminaux du collagène de type I, l’ostéocalcine sérique, la parathormone, la 25 hydroxy-vitamine D et l'interleukine-6 ont été dosés chez 67 patients atteints de maladies inflammatoires chroniques de l’intestin et 54 sujets sains appariés selon l'âge et le sexe. La densité minérale osseuse a été mesurée par l’absorptiométrie biphotonique aux rayons X et l'ostéoporose a été définie par un T score <-2,5 DS.
résultats: Les patients ont montré des taux significativement plus élevés des télopeptides C-terminaux du collagène de type I et d'interleukine-6, et plus bas de 25 hydroxy vitamine D.
L’ostéocalcine et la parathormone étaient normaux. En analyse multivariée, les télopeptides C-terminaux du collagène de type I étaient associés à l'activité de la maladie (p = 0,04) et l'ostéocalcine a été associée à la parathormone (p = 0,04). Les télopeptides Cterminaux du collagène de type I et l'interleukine-6 étaient significativement augmentés chez les patients avec ostéoporose. Absence d’association entre l'ostéoporose et l'ostéocalcine sérique, la parathormone et la 25 hydroxy vitamine D.
Conclusion: La résorption osseuse est augmentée et est associée à l'ostéoporose chez les patients atteints de maladies inflammatoires chroniques de l’intestin. L'inflammation, la malnutrition et l'hypovitaminose D peuvent contribuer à cette perte osseuse.
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