Background: Most of the studies that have investigated bone quality in inflammatory bowel disease (IBD) have utilized dual-energy X-ray absorptiometry (DXA). We assessed the bone status of IBD adult patients using a comprehensive array of non-invasive techniques.

Methods: Fifty IBD patients (30 women) and 50 healthy volunteers-matched for age, gender, and body mass index-were prospectively recruited. Areal bone mineral density (aBMD) at the anteroposterior and lateral spine and the proximal femur was measured by DXA, including vertebral fracture assessment (VFA). Trabecular bone score (TBS), calcaneal quantitative ultrasound (QUS), volumetric bone mineral density (vBMD), and cortical thickness were assessed in the proximal femur with 3D-DXA. A comprehensive laboratory panel of calcium metabolism and bone turnover markers was included.

Results: Twenty-nine and 21 patients were diagnosed with ulcerative colitis (UC) and Crohn's disease (CD), respectively. VFA identified vertebral fractures in two IBD patients and no controls. No statistically significant differences were observed in TBS, aBMD, and vBMD between IBD and healthy controls. After excluding one predefined outlier, broadband ultrasound attenuation (BUA) showed lower values in IBD vs. controls [103.6 ± 14.3 vs. 111.3 ± 19.5 (p = 0.033)]. QUS analysis revealed statistically lower values in the CD group compared to controls. We found a positive correlation between all the QUS parameters with aBMD and vBMD.

Conclusions: In our study of IBD subjects, most of whom had mild or quiescent disease, we did not observe significant bone quality deterioration. QUS was the only technique that showed lower values in IBD patients, especially in CD.