nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»nogr-454Research ArticleКЛИНИЧЕСКАЯ ГАСТРОЭНТЕРОЛОГИЯCLINICAL GASTROENTEROLOGYОЦЕНКА СОСТОЯНИЯ КОСТНОЙ МИНЕРАЛИЗАЦИИ И КОСТНОГО МЕТАБОЛИЗМА У ДЕТЕЙ С ВОСПАЛИТЕЛЬНЫМИ ЗАБОЛЕВАНИЯМИ КИШЕЧНИКАASSESSMENT OF BONE MINERALIZATION AND BONE METABOLISM IN CHILDREN WITH INFLAMMATORY BOWEL DISEASEГабрусскаяТ. В.GabrusskayaT. V.tatyanagabrusskaya@yandex.ruРевноваМ. О.RevnovaM. O.noemail@neicon.ruКузьминаД. А.KuzminaD. A.noemail@neicon.ruКостикМ. М.KostikM. M.noemail@neicon.ruФГБОУ ВО Санкт-Петербургский государственный педиатрический медицинский университет Минздрава РФРоссияSaint-Petersburg state pediatric medical UniversityRussian FederationФГБОУ ВО Северо-Западный государственный медицинский университет им. И. И. Мечникова Минздрава РФРоссияNorth-Western state medical University n. a. I. I. MechnikovRussian Federation201720072017077181Copyright © Габрусская Т.В., Ревнова М.О., Кузьмина Д.А., Костик М.М., 20172017Габрусская Т.В., Ревнова М.О., Кузьмина Д.А., Костик М.М.Gabrusskaya T.V., Revnova M.O., Kuzmina D.A., Kostik M.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/454

Цель: Изучить особенности состояния процессов минерализации осевого скелета и костного метаболизма ткани у детей с БК и ЯК. Материалы и методы: В исследование включено 113 пациентов с воспалительными заболеваниями кишечника (ВЗК) (2-17 лет), и 40 здоровых детей. У пациентов с ВЗК оценивали клинические и лабораторные маркеры активности. Оценку минерализации скелета проводили с помощью двуэнергетической рентгеновской абсорбциометрии поясничного отдела позвоночника. Для оценки костного метаболизма определяли уровни остеокальцина (ОК), С-концевых телопептидов (СКТ), паратгормона (ПТГ), ионизированного кальция, щелочной фосфатазы (ОЩФ), 25(OH) витамина D. Результаты: Пациенты с БК и ЯК имели достоверно более низкие показатели МПК по сравнению со здоровыми детьми (Z-критерий, -1,4SD, -1,3SD и 0,31 SD, p=0,00001, соответственно). Достоверные отличия между группами детей с БК, ЯК и здоровыми детьми были выявлены в уровнях ПТГ (39,4 пг/мл, 41,7 пг/мл и 24,8 пг/мл, p=0,04, соответственно), СКТ (1,09 нг/мл, 1,08 нг/мл, 0,84 нг/мл, p=0,03). Различий в уровнях ОК между исследуемыми группами обнаружено не было. Выявлена положительная корреляция между МПК и уровнями альбумина, ОК, показателями линейного роста. Негативно влияли на МПК показатели активности ВЗК, длительность ВЗК, кумулятивная доза кортикостероидов. Доля детей с дефицитом витамина D среди пациентов с БК и ЯК составила 98 % и 94, 1 % соответственно. Выводы: у пациентов с ВЗК выявлено снижение МПК в сочетании с активацией процессов костной резорбции на фоне выраженного системного воспаления, воздействия системных стероидов, дефицита витамина D и кальция.

Objectives: The aim of our study was to evaluate bone mineralization and metabolism in children with Crohn’s Disease (CD) and ulcerative colitis (UC). Material and methods: 113 patients with inflammatory bowel disease (IBD) (2-17 years) and 40 healthy children were included in the present study. We assessed markers of IBD activity. Bone mineral density (BMD) of lumbar spine (DEXA), serum osteocalcin (OC), C-terminal telopeptides (CTT), parathyroid hormone (PTH), serum calcium, alkaline phosphatase and 25 (OH) vitamin D were measured. Results: BMD in patients with CD and UC were lower than in control group (Zscore -1,4 SD, -1,3 SD and 0,31 SD, p=0,00001, respectively). Differences in level of PTH (39,4 pg/ml, 41,7 pg/ml и 24,8 pg/ml, p=0,04), and CTT (1,09 pg/ml, 1,08 pg/ml, 0,84 ng/ml, p=0,03) between CD, UC and healthy patients respectively have been found. There were no differences in serum OC between groups. Positive correlation between BMD and albumin, OC concentration and linear growth have been detected. IBD activity and duration, cumulative steroid dose were negatively associated with BMD. Vitamin D deficiency was observed in 98 % and 94,1 % of children with CD and UC respectively. Conclusions: patients IBD have low bone mineral density with increased bone resorption due to systemic inflammation, steroids side effect, vitamin D and calcium deficiency.

ReferencesDuricova D, Fumery M, Annese V, Lakatos P, Peyrin-Biroulet L, Gower-Rousseau C. The natural history of Crohn’s disease in children: a review of population-based studies. Eur J Gastroenterol Hepatol. 2017 Feb;29(2):125-134. doi: 10.1097/MEG.0000000000000761.Duricova D, Fumery M, Annese V, Lakatos P, Peyrin-Biroulet L, Gower-Rousseau C. The natural history of Crohn’s disease in children: a review of population-based studies. Eur J Gastroenterol Hepatol. 2017 Feb;29(2):125-134. doi: 10.1097/MEG.0000000000000761.Virta L, Saarinen M, Kolho K. Inflammatory bowel disease incidence is on the continuous rise among all paediatric patients except for the very young: A Nationwide Registry-based Study on 28-Year Follow-up. Crohns Colitis 2017 Feb 23;11(2):150-156. Epub 2016 Aug 23.Virta L, Saarinen M, Kolho K. Inflammatory bowel disease incidence is on the continuous rise among all paediatric patients except for the very young: A Nationwide Registry-based Study on 28-Year Follow-up. Crohns Colitis 2017 Feb 23;11(2):150-156. Epub 2016 Aug 23.Malmborg P, Hildebrand H. The emerging global epidemic of paediatric inflammatory bowel disease - causes and consequences. J Intern Med. 2016 Mar;279(3):241-58. doi: 10.1111/joim.12413. Epub 2015 Sep 10.Malmborg P, Hildebrand H. The emerging global epidemic of paediatric inflammatory bowel disease - causes and consequences. J Intern Med. 2016 Mar;279(3):241-58. doi: 10.1111/joim.12413. Epub 2015 Sep 10.Gasparetto M, Guariso G. Highlights in IBD epidemiology and its natural history in the paediatric age. Gastroenterol Res Pract. 2013;2013:829040. doi: 10.1155/2013/829040. Epub 2013 Dec 24.Gasparetto M, Guariso G. Highlights in IBD epidemiology and its natural history in the paediatric age. Gastroenterol Res Pract. 2013;2013:829040. doi: 10.1155/2013/829040. Epub 2013 Dec 24.Корниенко Е. А. Воспалительные заболевания кишечника у детей. Москва, 2014.Корниенко Е. А. Воспалительные заболевания кишечника у детей. Москва, 2014.Marineaţă A, Rezuş E, Mihai C, Prelipcean C. Extraintestinal manifestations and complications in inflammatory bowel disease. Rev Med Chir Soc Med Nat Iasi. 2014 Apr-Jun;118(2):279-88.Marineaţă A, Rezuş E, Mihai C, Prelipcean C. Extraintestinal manifestations and complications in inflammatory bowel disease. Rev Med Chir Soc Med Nat Iasi. 2014 Apr-Jun;118(2):279-88.Ley D, Duhamel A, Behal H, Vasseur F, Sarter H, Michaud L, Gower-Rousseau C, Turck D. Growth pattern in paediatric Crohn disease is related to inflammatory status. J Pediatr Gastroenterol Nutr. 2016 Dec;63(6):637-643.Ley D, Duhamel A, Behal H, Vasseur F, Sarter H, Michaud L, Gower-Rousseau C, Turck D. Growth pattern in paediatric Crohn disease is related to inflammatory status. J Pediatr Gastroenterol Nutr. 2016 Dec;63(6):637-643.Compston JE, Judd D, Crawley EO, Evans WD, Evans C, Church HA, Reid EM, Rhodes J. Osteoporosis in patients with inflammatory bowel disease. Gut 1987;28:410-5.Compston JE, Judd D, Crawley EO, Evans WD, Evans C, Church HA, Reid EM, Rhodes J. Osteoporosis in patients with inflammatory bowel disease. Gut 1987;28:410-5.Dinca M, Fries W, Luisetto G, Peccolo F, Bottega F, Leone L, Naccarato R, Martin A. Evolution of osteopenia in inflammatory bowel disease. Am J Gastroenterol 1999;94:1292-7.Dinca M, Fries W, Luisetto G, Peccolo F, Bottega F, Leone L, Naccarato R, Martin A. Evolution of osteopenia in inflammatory bowel disease. Am J Gastroenterol 1999;94:1292-7.Bjarnason I1, Macpherson A, Mackintosh C, Buxton-Thomas M, Forgacs I, Moniz C. Reduced bone density in patients with inflammatory bowel disease. Gut 1997;40:228-33.Bjarnason I1, Macpherson A, Mackintosh C, Buxton-Thomas M, Forgacs I, Moniz C. Reduced bone density in patients with inflammatory bowel disease. Gut 1997;40:228-33.Pollak RD, Karmeli F, Eliakim R, Ackerman Z, Tabb K, Rachmilewitz D. Femoral neck osteopenia in patients with inflammatory bowel disease. Am J Gastroenterol 1998;93:1483-90.Pollak RD, Karmeli F, Eliakim R, Ackerman Z, Tabb K, Rachmilewitz D. Femoral neck osteopenia in patients with inflammatory bowel disease. Am J Gastroenterol 1998;93:1483-90.Jahnsen J, Falch JA, Mowinckel P, Aadland E. Bone mineral density in patients with inflammatory bowel disease: a population-based prospective two-year follow-up study. Scand J Gastroenterol 2004;39:145-53.Jahnsen J, Falch JA, Mowinckel P, Aadland E. Bone mineral density in patients with inflammatory bowel disease: a population-based prospective two-year follow-up study. Scand J Gastroenterol 2004;39:145-53.Ardizzone S, Bollani S, Bettica P, Bevilacqua M, Molteni P, Bianchi Porro G. Altered bone metabolism in inflammatory bowel disease: there is a difference between Crohn’s disease and ulcerative colitis. J Intern Med 2000;247:63-70.Ardizzone S, Bollani S, Bettica P, Bevilacqua M, Molteni P, Bianchi Porro G. Altered bone metabolism in inflammatory bowel disease: there is a difference between Crohn’s disease and ulcerative colitis. J Intern Med 2000;247:63-70.Bernstein CN, Blanchard JF, Leslie W, Wajda A, Yu BN. The incidence of fracture among patients with inflammatory bowel disease. A population-based cohort study. Ann Intern Med 2000;133:795-9.Bernstein CN, Blanchard JF, Leslie W, Wajda A, Yu BN. The incidence of fracture among patients with inflammatory bowel disease. A population-based cohort study. Ann Intern Med 2000;133:795-9.Card T, West J, Hubbard R, Logan RF. Hip fractures in patients with inflammatory bowel disease and their relationship to corticosteroid use: a population based cohort study. Gut 2004;53:251-5.Card T, West J, Hubbard R, Logan RF. Hip fractures in patients with inflammatory bowel disease and their relationship to corticosteroid use: a population based cohort study. Gut 2004;53:251-5.Ruemmele FM, Veres G, Kolho KL, Griffiths A, Levine A, Escher JC, Amil Dias J, Barabino A, Braegger CP, Bronsky J, Buderus S, Martín-de-Carpi J, De Ridder L, Fagerberg UL, Hugot JP, Kierkus J, Kolacek S, Koletzko S et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis. 2014 Oct;8(10):1179-207. doi: 10.1016/j.crohns.2014.04.005. Epub 2014 Jun 6.Ruemmele FM, Veres G, Kolho KL, Griffiths A, Levine A, Escher JC, Amil Dias J, Barabino A, Braegger CP, Bronsky J, Buderus S, Martín-de-Carpi J, De Ridder L, Fagerberg UL, Hugot JP, Kierkus J, Kolacek S, Koletzko S et al. Consensus guidelines of ECCO/ESPGHAN on the medical management of pediatric Crohn’s disease. J Crohns Colitis. 2014 Oct;8(10):1179-207. doi: 10.1016/j.crohns.2014.04.005. Epub 2014 Jun 6.Turner D, Levine A, Escher JC, Griffiths AM, Russell RK, Dignass A, Dias JA, Bronsky J, Braegger CP, Cucchiara S, de Ridder L, Fagerberg UL, Hussey S, Hugot JP, Kolacek S, Kolho KL, Lionetti P, Paerregaard A, Potapov A, Rintala R, Serban DE, Staiano A, Sweeny B, Veerman G, Veres G, Wilson DC, Ruemmele FM. Management of pediatric ulcerative colitis: joint ECCO and ESPGHAN evidence-based consensus guidelines. J Pediatr Gastroenterol Nutr. 2012 Sep;55(3):340-61.Turner D, Levine A, Escher JC, Griffiths AM, Russell RK, Dignass A, Dias JA, Bronsky J, Braegger CP, Cucchiara S, de Ridder L, Fagerberg UL, Hussey S, Hugot JP, Kolacek S, Kolho KL, Lionetti P, Paerregaard A, Potapov A, Rintala R, Serban DE, Staiano A, Sweeny B, Veerman G, Veres G, Wilson DC, Ruemmele FM. Management of pediatric ulcerative colitis: joint ECCO and ESPGHAN evidence-based consensus guidelines. J Pediatr Gastroenterol Nutr. 2012 Sep;55(3):340-61.Баранов А. А., Намазова- Баранова Л. С., Потапов А. С., Алиева Э. И., Габрузская Т. В., Горелов А. В., Захарова И. Н., Корниенко Е. А., Панфилова В. Н., Печкуров Д.В, Ратникова М.А, Ревнова М. О., Ситникова Е. П., Урсов Н. И., Федулова Э. Н., Цимбалова Е.Г, Шумилов П. В., Щербакова О.В, Щиголева Н. Е. и др. Клиническая картина, диагностика и лечение язвенного колита у детей: Российский педиатрический консенсус. Вопросы современной педиатрии. 2013; 12 (3): 18-30Баранов А. А., Намазова- Баранова Л. С., Потапов А. С., Алиева Э. И., Габрузская Т. В., Горелов А. В., Захарова И. Н., Корниенко Е. А., Панфилова В. Н., Печкуров Д.В, Ратникова М.А, Ревнова М. О., Ситникова Е. П., Урсов Н. И., Федулова Э. Н., Цимбалова Е.Г, Шумилов П. В., Щербакова О.В, Щиголева Н. Е. и др. Клиническая картина, диагностика и лечение язвенного колита у детей: Российский педиатрический консенсус. Вопросы современной педиатрии. 2013; 12 (3): 18-30Потапов А. С. Болезнь Крона у детей и подростков. Клинические рекомендации по диагностике и лечению. М., 2010, 13 с.Потапов А. С. Болезнь Крона у детей и подростков. Клинические рекомендации по диагностике и лечению. М., 2010, 13 с.Semeao E, Stallings V, Peck S, Piccoli D. Vertebral compression fractures in pediatric patients with Crohn’s disease. Gastroenterology. 1997; 112(5): 1710-1713.Semeao E, Stallings V, Peck S, Piccoli D. Vertebral compression fractures in pediatric patients with Crohn’s disease. Gastroenterology. 1997; 112(5): 1710-1713.Johnell O1, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, Eisman JA, Fujiwara S, Kroger H, Mellstrom D, Meunier PJ, Melton LJ 3rd, O’Neill T, Pols H, Reeve J, Silman A, Tenenhouse A. Predictive value of BMD for hip and other fractures. J Bone Miner Res 2005;20:1185-94Johnell O1, Kanis JA, Oden A, Johansson H, De Laet C, Delmas P, Eisman JA, Fujiwara S, Kroger H, Mellstrom D, Meunier PJ, Melton LJ 3rd, O’Neill T, Pols H, Reeve J, Silman A, Tenenhouse A. Predictive value of BMD for hip and other fractures. J Bone Miner Res 2005;20:1185-94Clark E, Ness A, Bishop N, Tobias J. Association between bone density and fractures in children. Pediatrics. 2006 February; 117(2): e291-e297. doi:10.1542/peds.2005-1404.Clark E, Ness A, Bishop N, Tobias J. Association between bone density and fractures in children. Pediatrics. 2006 February; 117(2): e291-e297. doi:10.1542/peds.2005-1404.Laakso S, Valta H, Verkasalo M, Toiviainen-Salo S, Viljakainen H, Mäkitie O. Impaired bone health in inflammatory bowel disease: a case-control study in 80 pediatric patients. Calcif Tissue Int. 2012 Aug;91(2):121-30. doi: 10.1007/s00223-012-9617-2. Epub 2012 Jun 23.Laakso S, Valta H, Verkasalo M, Toiviainen-Salo S, Viljakainen H, Mäkitie O. Impaired bone health in inflammatory bowel disease: a case-control study in 80 pediatric patients. Calcif Tissue Int. 2012 Aug;91(2):121-30. doi: 10.1007/s00223-012-9617-2. Epub 2012 Jun 23.Burnham JM, Shults J, Semeao E, Foster B, Zemel BS, Stallings VA, Leonard MB. Whole body BMC in pediatric Crohn’s disease: independent effects of altered growth, maturation, and body composition. J Bone Miner Res. 2004;19:1961-1968.Burnham JM, Shults J, Semeao E, Foster B, Zemel BS, Stallings VA, Leonard MB. Whole body BMC in pediatric Crohn’s disease: independent effects of altered growth, maturation, and body composition. J Bone Miner Res. 2004;19:1961-1968.Sylvester F, Leopold S, Lincoln M, Hyams J, Griffiths A, Lerer T. A two-year longitudinal study of persistent lean tissue deficits in children with Crohn’s disease. Clin Gastroenterol Hepatol 2009;7:452-5.Sylvester F, Leopold S, Lincoln M, Hyams J, Griffiths A, Lerer T. A two-year longitudinal study of persistent lean tissue deficits in children with Crohn’s disease. Clin Gastroenterol Hepatol 2009;7:452-5.Schmidt S, Mellström D, Norjavaara E, Sundh S, Saalman R. Low bone mineral density in children and adolescents with inflammatory bowel disease: a population-based study from Western Sweden. Inflamm Bowel Dis. 2009 Dec;15(12):1844-50. doi: 10.1002/ibd.20962. Epub 2009 Apr 30Schmidt S, Mellström D, Norjavaara E, Sundh S, Saalman R. Low bone mineral density in children and adolescents with inflammatory bowel disease: a population-based study from Western Sweden. Inflamm Bowel Dis. 2009 Dec;15(12):1844-50. doi: 10.1002/ibd.20962. Epub 2009 Apr 30Schmidt S, Mellström D, Norjavaara E, Sundh V, Saalman R. Longitudinal assessment of bone mineral density in children and adolescents with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2012 Nov;55(5):511-8. doi: 10.1097/MPG.0b013e31825817a0.Schmidt S, Mellström D, Norjavaara E, Sundh V, Saalman R. Longitudinal assessment of bone mineral density in children and adolescents with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2012 Nov;55(5):511-8. doi: 10.1097/MPG.0b013e31825817a0.Szumera M, Landowski P, Kamińska B, Góra-Gebka M, Popadiuk S, Renke J. Bone mineral density in inflammatory bowel diseases in children. Med Wieku Rozwoj.2006;10(2):445-51.Szumera M, Landowski P, Kamińska B, Góra-Gebka M, Popadiuk S, Renke J. Bone mineral density in inflammatory bowel diseases in children. Med Wieku Rozwoj.2006;10(2):445-51.Boot AM, Bouquet J, Krenning EP, de Muinck Keizer-Schrama SM. Bone Mineral Density and Nutritional Status in Children With Chronic Inflammatory Bowel Diseased Gut 1998;42(2), 188-194.Boot AM, Bouquet J, Krenning EP, de Muinck Keizer-Schrama SM. Bone Mineral Density and Nutritional Status in Children With Chronic Inflammatory Bowel Diseased Gut 1998;42(2), 188-194.Laakso S, Valta H, Verkasalo M, Toiviainen-Salo S, Makitie. Compromised peak bone Mass in Patients with Inflammatory Bowel Disease-A Prospective Study. Pediatr 2014;164:1436-43.Laakso S, Valta H, Verkasalo M, Toiviainen-Salo S, Makitie. Compromised peak bone Mass in Patients with Inflammatory Bowel Disease-A Prospective Study. Pediatr 2014;164:1436-43.Kappelman M., Galanko J., Porter C., Sandler S. The risk of diagnosed fractures in children with inflammatory bowel diseases. Inflamm Bowel Dis. 2011 May; 17(5): 1125-1130.Kappelman M., Galanko J., Porter C., Sandler S. The risk of diagnosed fractures in children with inflammatory bowel diseases. Inflamm Bowel Dis. 2011 May; 17(5): 1125-1130.Landin LA. Fracture patterns in children. Analysis of 8682 fractures with special reference to incidence, etiology and secular changes in a Swedish urban population 1950-1979. Acta Orthop Scand Suppl. 1983;202: 1-109.Landin LA. Fracture patterns in children. Analysis of 8682 fractures with special reference to incidence, etiology and secular changes in a Swedish urban population 1950-1979. Acta Orthop Scand Suppl. 1983;202: 1-109.Khosla S, Melton LJ 3rd, Dekutoski M, Achenbach S, Ober A, Riggs B. Incidence of childhood distal forearm fractures over 30 years: population-based study. JAMA. 2003; 290:1479-85.Khosla S, Melton LJ 3rd, Dekutoski M, Achenbach S, Ober A, Riggs B. Incidence of childhood distal forearm fractures over 30 years: population-based study. JAMA. 2003; 290:1479-85.Semeao E, Stallings V, Peck S, Piccoli D. Vertebral compression fractures in pediatric patients with Crohn’s disease. Gut. 2002; 51:654-8.Semeao E, Stallings V, Peck S, Piccoli D. Vertebral compression fractures in pediatric patients with Crohn’s disease. Gut. 2002; 51:654-8.Mauro M, Armstrong D. Juvenile onset of Crohn’s disease: a risk factor for reduced lumbar bone mass in premenopausal women. Bone. 2007 May;40(5):1290-3. Epub 2007 Jan 17.Mauro M, Armstrong D. Juvenile onset of Crohn’s disease: a risk factor for reduced lumbar bone mass in premenopausal women. Bone. 2007 May;40(5):1290-3. Epub 2007 Jan 17.Pichler J, Huber W, Aufricht C, Bidmon-Fliegenschnee B. Growth and bone health in paediatric patients with Crohn’s disease receiving subcutaneous tumor necrosis factor antibody. World J Gastroenterol. 2015 Jun 7; 21(21): 6613-6620.Pichler J, Huber W, Aufricht C, Bidmon-Fliegenschnee B. Growth and bone health in paediatric patients with Crohn’s disease receiving subcutaneous tumor necrosis factor antibody. World J Gastroenterol. 2015 Jun 7; 21(21): 6613-6620.Lindsay M. Griffin, Meena Thayu, Robert N. Baldassano, Mark D. DeBoer, Babette S. Zemel, Michelle R. Denburg, Lee A. Denson, Justine Shults, Rita Herskovitz, Jin Long, and Mary B. Leonard Improvements in Bone Density and Structure during Anti-TNF-α Therapy in Pediatric Crohn’s Disease. J Clin Endocrinol Metab. 2015 Jul; 100(7): 2630-2639.Lindsay M. Griffin, Meena Thayu, Robert N. Baldassano, Mark D. DeBoer, Babette S. Zemel, Michelle R. Denburg, Lee A. Denson, Justine Shults, Rita Herskovitz, Jin Long, and Mary B. Leonard Improvements in Bone Density and Structure during Anti-TNF-α Therapy in Pediatric Crohn’s Disease. J Clin Endocrinol Metab. 2015 Jul; 100(7): 2630-2639.Sands BE. Biomarkers of Inflammation in Inflammatory Bowel Disease. Gastroenterology. 2015 Oct;149(5):1275-1285.e2. doi: 10.1053/j.gastro.2015.07.003.Sands BE. Biomarkers of Inflammation in Inflammatory Bowel Disease. Gastroenterology. 2015 Oct;149(5):1275-1285.e2. doi: 10.1053/j.gastro.2015.07.003.Ghosh S, Cowen S, Hannan WJ, Ferguson A. Low bone mineral density in Crohn’s disease, but not in ulcerative colitis, at diagnosis. Gastroenterology 1994; 107:1031-1039.Ghosh S, Cowen S, Hannan WJ, Ferguson A. Low bone mineral density in Crohn’s disease, but not in ulcerative colitis, at diagnosis. Gastroenterology 1994; 107:1031-1039.Ryan JG, Morgan RK, Lavin PJ, Murray FE, O’Connell PG. Current management of corticosteroid-induced osteoporosis: variations in awareness and management. Ir J Med Sci. 2004 Jan-Mar;173(1):20-2.Ryan JG, Morgan RK, Lavin PJ, Murray FE, O’Connell PG. Current management of corticosteroid-induced osteoporosis: variations in awareness and management. Ir J Med Sci. 2004 Jan-Mar;173(1):20-2.Bernstein C., Leslie W. Therapy insight: Osteoporosis in inflammatory bowel disease - advances and retreats. Nat Clin Pract Gastroenterol Hepatol. 2005 May;2(5):232-9.Bernstein C., Leslie W. Therapy insight: Osteoporosis in inflammatory bowel disease - advances and retreats. Nat Clin Pract Gastroenterol Hepatol. 2005 May;2(5):232-9.Veerappan S, Healy M, Walsh B, O’Morain C, Daly J, Ryan B. Adalimumab Therapy Has a Beneficial Effect on Bone Metabolism in Patients with Crohn’s Disease. Dig Dis Sci 2015; 60:2119-2129.Veerappan S, Healy M, Walsh B, O’Morain C, Daly J, Ryan B. Adalimumab Therapy Has a Beneficial Effect on Bone Metabolism in Patients with Crohn’s Disease. Dig Dis Sci 2015; 60:2119-2129.Card T, West J, Hubbard R, Logan RF. Hip fractures in patients with inflammatory bowel disease and their relationship to corticosteroid use: a population based cohort study. Gut 2004; 53:251-255.Card T, West J, Hubbard R, Logan RF. Hip fractures in patients with inflammatory bowel disease and their relationship to corticosteroid use: a population based cohort study. Gut 2004; 53:251-255.van Staa TP. The pathogenesis, epidemiology and management of glucocorticoid-induced osteoporosis. Calcif Tissue Int 2006; 79:129-137.van Staa TP. The pathogenesis, epidemiology and management of glucocorticoid-induced osteoporosis. Calcif Tissue Int 2006; 79:129-137.Bernstein C, Blanchard J, Metge C, Yogendran M. The association between corticosteroid use and development of fractures among IBD patients in a population-based database. Am J Gastroenterol 2003; 98:1797-1801.Bernstein C, Blanchard J, Metge C, Yogendran M. The association between corticosteroid use and development of fractures among IBD patients in a population-based database. Am J Gastroenterol 2003; 98:1797-1801.Ford AC 1, Bernstein CN, Khan KJ, Abreu MT, Marshall JK, Talley NJ, Moayyedi P. Glucocorticosteroid therapy in inflammatory bowel disease: systematic review and meta-analysis. Am J Gastroenterol. 2011 Apr;106(4):590-9; quiz 600. doi: 10.1038/ajg.2011.70. Epub 2011 Mar 15.Ford AC 1, Bernstein CN, Khan KJ, Abreu MT, Marshall JK, Talley NJ, Moayyedi P. Glucocorticosteroid therapy in inflammatory bowel disease: systematic review and meta-analysis. Am J Gastroenterol. 2011 Apr;106(4):590-9; quiz 600. doi: 10.1038/ajg.2011.70. Epub 2011 Mar 15.Gudbjornsson B, Juliusson UI, Gudjonsson FV. Prevalence of long term steroid treatment and the frequency of decision making to prevent steroid induced osteoporosis in daily clinical practice. Ann Rheum Dis, 2002, 61(1):32-36.Gudbjornsson B, Juliusson UI, Gudjonsson FV. Prevalence of long term steroid treatment and the frequency of decision making to prevent steroid induced osteoporosis in daily clinical practice. Ann Rheum Dis, 2002, 61(1):32-36.van Staa T, Leufkens H, Cooper C. The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int, 2002, 13(10):777-787van Staa T, Leufkens H, Cooper C. The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis. Osteoporos Int, 2002, 13(10):777-787Van Staa T, Leufkens H, Abenhaim L, Zhang B, Cooper C (2000) Use of oral corticosteroids and risk of fractures. J Bone Miner Res 15(6):993-1000Van Staa T, Leufkens H, Abenhaim L, Zhang B, Cooper C (2000) Use of oral corticosteroids and risk of fractures. J Bone Miner Res 15(6):993-1000Dubner SE, Shults J, Baldassano RN, Zemel BS, Thayu M, Burnham JM, Herskovitz RM, Howard KM, Leonard MB. Longitudinal assessment of bone density and structure in an incident cohort of children with Crohn’s disease. Gastroenterology. 2009; 136:123-30.Dubner SE, Shults J, Baldassano RN, Zemel BS, Thayu M, Burnham JM, Herskovitz RM, Howard KM, Leonard MB. Longitudinal assessment of bone density and structure in an incident cohort of children with Crohn’s disease. Gastroenterology. 2009; 136:123-30.Lopes L, Sdepanian V, Szejnfeld V, de Morais M, Fagundes-Neto U. Risk factors for low bone mineral density in children and adolescents with inflammatory bowel disease. Dig Dis Sci 2008; 53: 2746-53.Lopes L, Sdepanian V, Szejnfeld V, de Morais M, Fagundes-Neto U. Risk factors for low bone mineral density in children and adolescents with inflammatory bowel disease. Dig Dis Sci 2008; 53: 2746-53.Boot A, Bouquet J, Krenning E, de Munck Kezer-Schrama S. Bone mineral density in children and adolescents with inflammatory bowel disease: a population-based study from Western Swede. Inflamm Bowel Dis Sci 2008; 53: 2746-53.Boot A, Bouquet J, Krenning E, de Munck Kezer-Schrama S. Bone mineral density in children and adolescents with inflammatory bowel disease: a population-based study from Western Swede. Inflamm Bowel Dis Sci 2008; 53: 2746-53.van Staa, Leufkens HG, Cooper C. The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis.Osteoporosis Int. 2002.;13 777-787van Staa, Leufkens HG, Cooper C. The epidemiology of corticosteroid-induced osteoporosis: a meta-analysis.Osteoporosis Int. 2002.;13 777-787Levine A, Broide E, Stein M, Bujanover Y, Weizman Z, Dinari G, Pacht A, Branski D, Zahavi I. Evaluation of oral budesonide for treatment of mild and moderate exacerbations of Crohn’s disease in children. J Pediatr 2002;140:75-80.Levine A, Broide E, Stein M, Bujanover Y, Weizman Z, Dinari G, Pacht A, Branski D, Zahavi I. Evaluation of oral budesonide for treatment of mild and moderate exacerbations of Crohn’s disease in children. J Pediatr 2002;140:75-80.Holick M, Binkley N, Bischoff-Ferrari H, Gordon C, Hanley D, Heaney R. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2011;96:1911-30.Holick M, Binkley N, Bischoff-Ferrari H, Gordon C, Hanley D, Heaney R. Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2011;96:1911-30.Priemel M, von Domarus C, Klatte TO, Kessler S, Schlie J, Meier S, Proksch N, Pastor F, Netter C, Streichert T, Püschel K, Amling M. Bone mineralization defects and vitamin D deficiency: histomorphometric analysis of iliac crest bone biopsies and circulating 25- hydroxyvitamin D in 675 patients. J Bone Miner Res 2010;25:305-12.Priemel M, von Domarus C, Klatte TO, Kessler S, Schlie J, Meier S, Proksch N, Pastor F, Netter C, Streichert T, Püschel K, Amling M. Bone mineralization defects and vitamin D deficiency: histomorphometric analysis of iliac crest bone biopsies and circulating 25- hydroxyvitamin D in 675 patients. J Bone Miner Res 2010;25:305-12.Alkhouri R, Hashmi H, Baker R, Gelfond D, Baker S. Vitamin and mineral status in patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2013; 56:89-92.Alkhouri R, Hashmi H, Baker R, Gelfond D, Baker S. Vitamin and mineral status in patients with inflammatory bowel disease. J Pediatr Gastroenterol Nutr. 2013; 56:89-92.Leslie W, Miller N, Rogala L, Bernstein C. Vitamin D status and bone density in recently diagnosed inflammatory bowel disease: the Manitoba IBD Cohort Study. Am J Gastroenterol. 2008; 103:1451-9.Leslie W, Miller N, Rogala L, Bernstein C. Vitamin D status and bone density in recently diagnosed inflammatory bowel disease: the Manitoba IBD Cohort Study. Am J Gastroenterol. 2008; 103:1451-9.Gilman J, Shanahan F, Cashman KD. Determinants of vitamin D status in adult Crohn’s disease patients, with particular emphasis on supplemental vitamin D use. Eur J Clin Nutr. 2006; 60:889-96.Gilman J, Shanahan F, Cashman KD. Determinants of vitamin D status in adult Crohn’s disease patients, with particular emphasis on supplemental vitamin D use. Eur J Clin Nutr. 2006; 60:889-96.McCarthy D, Duggan P, O’Brien M, Kiely M, McCarthy J, Shanahan F, Cashman KD. Seasonality of vitamin D status and bone turnover in patients with Crohn’s disease. Aliment Pharmacol Ther. 2005; 21:1073-83.McCarthy D, Duggan P, O’Brien M, Kiely M, McCarthy J, Shanahan F, Cashman KD. Seasonality of vitamin D status and bone turnover in patients with Crohn’s disease. Aliment Pharmacol Ther. 2005; 21:1073-83.Levin A, Wadhera V, Leach S, Woodhead H, Lemberg D, Mendoza-Cruz A, Day A. Vitamin D deficiency in children with inflammatory bowel disease. Dig Dis Sci. 2011; 56:830-6.Levin A, Wadhera V, Leach S, Woodhead H, Lemberg D, Mendoza-Cruz A, Day A. Vitamin D deficiency in children with inflammatory bowel disease. Dig Dis Sci. 2011; 56:830-6.Ulitsky A, Ananthakrishnan AN, Naik A, Skaros S, Zadvornova Y, Binion DG, Issa M. Vitamin D deficiency in patients with inflammatory bowel disease: association with disease activity and quality of life. JPEN J Parenter Enteral Nutr. 2011;35(3):308-16.Ulitsky A, Ananthakrishnan AN, Naik A, Skaros S, Zadvornova Y, Binion DG, Issa M. Vitamin D deficiency in patients with inflammatory bowel disease: association with disease activity and quality of life. JPEN J Parenter Enteral Nutr. 2011;35(3):308-16.Leslie W, Miller N, Rogala L, Bernstein C. Vitamin D status and bone density in recently diagnosed inflammatory bowel disease: the Manitoba IBD Cohort Study. Am J Gastroenterol. 2008; 103:1451-9.Leslie W, Miller N, Rogala L, Bernstein C. Vitamin D status and bone density in recently diagnosed inflammatory bowel disease: the Manitoba IBD Cohort Study. Am J Gastroenterol. 2008; 103:1451-9.Gilman J, Shanahan F, Cashman K. Determinants of vitamin D status in adult Crohn’s disease patients, with particular emphasis on supplemental vitamin D use. Eur J Clin Nutr. 2006; 60:889-96.Gilman J, Shanahan F, Cashman K. Determinants of vitamin D status in adult Crohn’s disease patients, with particular emphasis on supplemental vitamin D use. Eur J Clin Nutr. 2006; 60:889-96.de Bruyn О, van Heeckeren R, Ponsioen С, van den Brink G, Löwenberg M, Bredenoord AJ, Frijstein G. Vitamin D deficiency in Crohn’s disease and healthy controls: A prospective case-control study in the Netherlands J Crohns Colitis. 2014 Mar 22. pii: S 1873-9946(14)00099-3. doi: 10.1016/j.crohns.2014.03.004de Bruyn О, van Heeckeren R, Ponsioen С, van den Brink G, Löwenberg M, Bredenoord AJ, Frijstein G. Vitamin D deficiency in Crohn’s disease and healthy controls: A prospective case-control study in the Netherlands J Crohns Colitis. 2014 Mar 22. pii: S 1873-9946(14)00099-3. doi: 10.1016/j.crohns.2014.03.004Торшин И.Ю, Громова О. А., Лиманова О. А., Сардарян И. С., Малявская С. И., Галустян А. Н., Волков А. Ю., Калачева А. Г., Гришина Т. Р., Громов А. Н., Рудаков К. В. Обеспеченность витамином D детей и подростков 7-14 лет и взаимосвязь дефицита витамина D с нарушениями здоровья детей. Анализ крупномасштабной выборки пациентов посредством интеллектуального анализа данных. Педиатрия им. Сперанского, 2015, No2., 175-185.Торшин И.Ю, Громова О. А., Лиманова О. А., Сардарян И. С., Малявская С. И., Галустян А. Н., Волков А. Ю., Калачева А. Г., Гришина Т. Р., Громов А. Н., Рудаков К. В. Обеспеченность витамином D детей и подростков 7-14 лет и взаимосвязь дефицита витамина D с нарушениями здоровья детей. Анализ крупномасштабной выборки пациентов посредством интеллектуального анализа данных. Педиатрия им. Сперанского, 2015, No2., 175-185.Захарова И. Н., Мальцев С. В., Боровик Т. Э., Яцык Г. В., Малявская С. И., Вахлова И. В., Шуматова Т. А., Романцова Е. Б., Романюк Ф. П., Климов.Я., Елкина Т. Н., Пирожкова Н. И., Колесникова С. М., Курьянинова В. А., Васильева С. В., Мозжухина М. В., Евсеева Е. А. Недостаточность витамина D у детей раннего возраста в России (результаты многоцентрового исследования - зима 2013-2014 гг.) // Педиатрия. -2014. - Том 93. - No2. - 75-80.Захарова И. Н., Мальцев С. В., Боровик Т. Э., Яцык Г. В., Малявская С. И., Вахлова И. В., Шуматова Т. А., Романцова Е. Б., Романюк Ф. П., Климов.Я., Елкина Т. Н., Пирожкова Н. И., Колесникова С. М., Курьянинова В. А., Васильева С. В., Мозжухина М. В., Евсеева Е. А. Недостаточность витамина D у детей раннего возраста в России (результаты многоцентрового исследования - зима 2013-2014 гг.) // Педиатрия. -2014. - Том 93. - No2. - 75-80.Яблокова Е. А. Клинические особенности и нарушение минерализации костной ткани у детей с воспалительными заболеваниями кишечника. Диссертация на соискание ученой степени кандидата медицинских наук. Москва, 2006.Яблокова Е. А. Клинические особенности и нарушение минерализации костной ткани у детей с воспалительными заболеваниями кишечника. Диссертация на соискание ученой степени кандидата медицинских наук. Москва, 2006.Abraham B, Prasad P, Malaty H. Vitamin D deficiency and corticosteroid use are risk factors for low bone mineral density in inflammatory bowel disease patients. Dig Dis Sci. 2014 Aug;59(8):1878-84. doi: 10.1007/s10620-014-3102-x. Epub 2014 Mar 12.Abraham B, Prasad P, Malaty H. Vitamin D deficiency and corticosteroid use are risk factors for low bone mineral density in inflammatory bowel disease patients. Dig Dis Sci. 2014 Aug;59(8):1878-84. doi: 10.1007/s10620-014-3102-x. Epub 2014 Mar 12.Панкратова Ю. В., Пигарова Е. А., Дзеранова Л. К. Витамин К-зависимые белки: остеокальцин, матриксный Gla-белок и их внекостные эффекты. Ожирение и метаболизм, № 2, 2013: 11-18.Панкратова Ю. В., Пигарова Е. А., Дзеранова Л. К. Витамин К-зависимые белки: остеокальцин, матриксный Gla-белок и их внекостные эффекты. Ожирение и метаболизм, № 2, 2013: 11-18.Sánchez Cano D, Ruiz-Villaverde R, Olvera Porcel M, Callejas Rubio JL, Pérez CC, García MG, Calvin JG, Ortego Centeno N. Evaluation of bone mineral density, bone turnover markers, the OPG/RANKL system and sTNF-RI in Crohn’s disease. Gastroenterol Hepatol. 2011 Jan;34(1):3-9. doi: 10.1016/j.gastrohep.2010.10.006. Epub 2011 Jan 8Sánchez Cano D, Ruiz-Villaverde R, Olvera Porcel M, Callejas Rubio JL, Pérez CC, García MG, Calvin JG, Ortego Centeno N. Evaluation of bone mineral density, bone turnover markers, the OPG/RANKL system and sTNF-RI in Crohn’s disease. Gastroenterol Hepatol. 2011 Jan;34(1):3-9. doi: 10.1016/j.gastrohep.2010.10.006. Epub 2011 Jan 8Silvennoinen J, Risteli L, Karttunen T, Risteli J. Increased degradation of type I collagen in patients with inflammatory bowel disease Gut 1996; 38: 223-228.Silvennoinen J, Risteli L, Karttunen T, Risteli J. Increased degradation of type I collagen in patients with inflammatory bowel disease Gut 1996; 38: 223-228.Park J, Jung S, Noh Y, Kang M, Jung J, Kim S, Jung H, Shim K, Kim T, Yoo K, Moon I, Hong Y. Analysis of risk factors for low bone mineral density in patients with inflammatory bowel disease. Korean J Gastroenterol. 2010 Apr;55(4):237-44.Park J, Jung S, Noh Y, Kang M, Jung J, Kim S, Jung H, Shim K, Kim T, Yoo K, Moon I, Hong Y. Analysis of risk factors for low bone mineral density in patients with inflammatory bowel disease. Korean J Gastroenterol. 2010 Apr;55(4):237-44.Gokhale R, Favus M, Karrison T, Sutton M, Rich B, Kirschner B. Bone mineral density assessment in children with inflammatory bowel disease. Gastroenterology. 1998 May;114(5):902-11.Gokhale R, Favus M, Karrison T, Sutton M, Rich B, Kirschner B. Bone mineral density assessment in children with inflammatory bowel disease. Gastroenterology. 1998 May;114(5):902-11.Veerappan S, Healy M, Walsh B, O’Morain C, Daly J, Ryan B. A 1-year prospective study of the effect of infliximab on bone metabolism in inflammatory bowel disease patients. Eur J Gastroenterol Hepatol. 2016 Nov;28(11):1335-44. doi: 10.1097/MEG.0000000000000719Veerappan S, Healy M, Walsh B, O’Morain C, Daly J, Ryan B. A 1-year prospective study of the effect of infliximab on bone metabolism in inflammatory bowel disease patients. Eur J Gastroenterol Hepatol. 2016 Nov;28(11):1335-44. doi: 10.1097/MEG.0000000000000719Veerappan S, Healy M, Walsh B, O’Morain C, Daly J, Ryan B. Adalimumab Therapy Has a Beneficial Effect on Bone Metabolism in Patients with Crohn’s Disease Dig Dis Sci. 2015 Jul;60(7):2119-29. doi: 10.1007/s10620-015-3606-z. Epub 2015 Mar 3Veerappan S, Healy M, Walsh B, O’Morain C, Daly J, Ryan B. Adalimumab Therapy Has a Beneficial Effect on Bone Metabolism in Patients with Crohn’s Disease Dig Dis Sci. 2015 Jul;60(7):2119-29. doi: 10.1007/s10620-015-3606-z. Epub 2015 Mar 3Franchimont N, Putzeys V, Collette J, Vermeire S, Rutgeerts P, De Vos M, Van Gossum A, Franchimont D, Fiasse R, Pelckmans P, Malaise M, Belaiche J, Louis E. Rapid improvement of bone metabolism after infliximab treatment in Crohn’s disease. Aliment Pharmacol Ther. 2004 Sep 15;20(6):607-14Franchimont N, Putzeys V, Collette J, Vermeire S, Rutgeerts P, De Vos M, Van Gossum A, Franchimont D, Fiasse R, Pelckmans P, Malaise M, Belaiche J, Louis E. Rapid improvement of bone metabolism after infliximab treatment in Crohn’s disease. Aliment Pharmacol Ther. 2004 Sep 15;20(6):607-14Miheller P1, Muzes G, Zágoni T, Tóth M, Rácz K, Tulassay Z. Improvement of bone metabolism after infliximab therapy in Crohn’s disease. Orv Hetil. 2005 Jul 10;146(28):1477-80.Miheller P1, Muzes G, Zágoni T, Tóth M, Rácz K, Tulassay Z. Improvement of bone metabolism after infliximab therapy in Crohn’s disease. Orv Hetil. 2005 Jul 10;146(28):1477-80.Szabó D, Hosszú É, Arató A, Müller K, Béres N, Lakatos P, Papp M, Dezsőfi A, Szabó A, Szűcs D, Veres G. Seasonal variabilit of vitamin D and bone metabolism in infliximab-treated paediatric Crohn’s disease. Dig Liver Dis. 2015 Aug;47(8):652-7 doi: 10.1016/j.dld.2015.05.006. Epub 2015 May 1Szabó D, Hosszú É, Arató A, Müller K, Béres N, Lakatos P, Papp M, Dezsőfi A, Szabó A, Szűcs D, Veres G. Seasonal variabilit of vitamin D and bone metabolism in infliximab-treated paediatric Crohn’s disease. Dig Liver Dis. 2015 Aug;47(8):652-7 doi: 10.1016/j.dld.2015.05.006. Epub 2015 May 1Griffiths A, Baldassano R, Walters T. Improvements of markers of bone metabolism with adalimumab in children with moderetly to severe active crohn disease: results from IMAgINE. European Gastroenterology Week, 12-16 October 2013, Berlin.Griffiths A, Baldassano R, Walters T. Improvements of markers of bone metabolism with adalimumab in children with moderetly to severe active crohn disease: results from IMAgINE. European Gastroenterology Week, 12-16 October 2013, Berlin.Visvanathan S, van der Heijde, Deodhar A, Wagner C, Baker D, Han J, Braun J. Effects of infliximab on markers of inflammation and bone turnover and associations with bone mineral density in patients with ankylosing spondylitis. Ann Rheum Dis. 2009 Feb; 68(2): 175-182. Published online 2008 May 21. doi: 10.1136/ard.2007.084426Visvanathan S, van der Heijde, Deodhar A, Wagner C, Baker D, Han J, Braun J. Effects of infliximab on markers of inflammation and bone turnover and associations with bone mineral density in patients with ankylosing spondylitis. Ann Rheum Dis. 2009 Feb; 68(2): 175-182. Published online 2008 May 21. doi: 10.1136/ard.2007.084426Walters T, Gilman A, Griffiths A. Linear growth improves during infliximab therapy in children with chronically active severe Crohn’s disease. Inflamm Bowel Dis. 2007 Apr;13(4):424-30.Walters T, Gilman A, Griffiths A. Linear growth improves during infliximab therapy in children with chronically active severe Crohn’s disease. Inflamm Bowel Dis. 2007 Apr;13(4):424-30.Tilg H, Moschen A, Kaser A, Pines A, Dotan I. Gut, inflammation and osteoporosis: basic and clinical concepts. Gut 2008;57:684-694.Tilg H, Moschen A, Kaser A, Pines A, Dotan I. Gut, inflammation and osteoporosis: basic and clinical concepts. Gut 2008;57:684-694.Theill L, Boyle W, Penninger J. RANK-L and RANK: T cells, bone loss, and mammalian evolution. Annu Rev Immunol 2002;20:795-823.Theill L, Boyle W, Penninger J. RANK-L and RANK: T cells, bone loss, and mammalian evolution. Annu Rev Immunol 2002;20:795-823.Silveonnoinen O, Risteli O, Karttunen T, Risteli O. Increased degradation oftype I collagen in patients with inflammatory bowel disease Gut 1996; 38: 223-228Silveonnoinen O, Risteli O, Karttunen T, Risteli O. Increased degradation oftype I collagen in patients with inflammatory bowel disease Gut 1996; 38: 223-228Bischoff S, Herrmann A, Göke M, Manns M, von zur Mühlen A, Brabant G., Orv Hetil. Altered bone metabolism in inflammatory bowel disease. Am J Gastroenterol. 1997 Jul;92(7):1157-63.Bischoff S, Herrmann A, Göke M, Manns M, von zur Mühlen A, Brabant G., Orv Hetil. Altered bone metabolism in inflammatory bowel disease. Am J Gastroenterol. 1997 Jul;92(7):1157-63.Miheller P, Tóth M, Molnár E, Zágoni T, Rácz K, Tulassay Z. Serum bone marker measurements in bone metabolism disorders associated with inflammatory bowel diseases. Orv Hetil. 2001 Jul 22;142(29):1557-60Miheller P, Tóth M, Molnár E, Zágoni T, Rácz K, Tulassay Z. Serum bone marker measurements in bone metabolism disorders associated with inflammatory bowel diseases. Orv Hetil. 2001 Jul 22;142(29):1557-60Thayu et al. Improvement in Biomarkers of Bone Formation During Infliximab Therapy in Pediatric Crohn’s Disease: Results of the REACH Study. Clinical gastroenterology and hepatology 2008;6:1378-1384.Thayu et al. Improvement in Biomarkers of Bone Formation During Infliximab Therapy in Pediatric Crohn’s Disease: Results of the REACH Study. Clinical gastroenterology and hepatology 2008;6:1378-1384.

The authors declare that there are no conflicts of interest present.