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Review article: Osteoporosis and inflammatory bowel disease.
Aliment Pharmacol Ther. 2004 May 01; 19(9):941-52.AP

Abstract

Studies using dual-energy X-ray absorptiometry have suggested a high prevalence of osteoporosis in inflammatory bowel disease. However, population-based data on fracture incidence suggest only a small increased risk of fracture amongst patients with inflammatory bowel disease compared with the general population. Therefore, it would be helpful to identify patients with inflammatory bowel disease at particularly high risk for fracture so that these risks might be modified or interventions might be undertaken. The data on calcium intake as a predictor of bone mineral density are conflicting. Although there are data suggesting that a one-time survey to determine current calcium intake will not help to predict bone mineral density in inflammatory bowel disease, persistently reduced calcium intake does appear to lead to lower bone mineral density. In the general population, body mass is strongly correlated with bone mineral density, which also appears to be true in Crohn's disease. Hence, subjects with inflammatory bowel disease and considerable weight loss, or who are obviously malnourished, could be considered for bone mineral density testing, and the finding of a low bone mineral density would suggest the need for more aggressive nutritional support. Although vitamin D is undoubtedly important in bone health, vitamin D intake and serum vitamin D levels do not correlate well with bone mineral density. Sex hormone deficiency can also adversely affect bone health, although a well-developed strategy for sex hormone measurements in patients with inflammatory bowel disease remains to be established. Ultimately, the determination of genetic mutations that accurately predict fracture susceptibility may be the best hope for developing a simplified strategy for managing bone health in inflammatory bowel disease. The therapy of osteoporosis in inflammatory bowel disease has been adapted from other osteoporosis settings, such as post-menopausal or corticosteroid-induced osteoporosis. To date, there remains no therapy proven to be efficacious in inflammatory bowel disease-related osteoporosis; however, calcium and vitamin D supplementation and bisphosphonates have their roles.

Authors+Show Affiliations

University of Manitoba Inflammatory Bowel Disease Clinical and Research Centre, and Manitoba Osteoporosis Programme, Winnipeg, Man., Canada. cbernst@cc.umanitoba.caNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

15113361

Citation

Bernstein, C N., and W D. Leslie. "Review Article: Osteoporosis and Inflammatory Bowel Disease." Alimentary Pharmacology & Therapeutics, vol. 19, no. 9, 2004, pp. 941-52.
Bernstein CN, Leslie WD. Review article: Osteoporosis and inflammatory bowel disease. Aliment Pharmacol Ther. 2004;19(9):941-52.
Bernstein, C. N., & Leslie, W. D. (2004). Review article: Osteoporosis and inflammatory bowel disease. Alimentary Pharmacology & Therapeutics, 19(9), 941-52.
Bernstein CN, Leslie WD. Review Article: Osteoporosis and Inflammatory Bowel Disease. Aliment Pharmacol Ther. 2004 May 1;19(9):941-52. PubMed PMID: 15113361.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Review article: Osteoporosis and inflammatory bowel disease. AU - Bernstein,C N, AU - Leslie,W D, PY - 2004/4/29/pubmed PY - 2004/8/31/medline PY - 2004/4/29/entrez SP - 941 EP - 52 JF - Alimentary pharmacology & therapeutics JO - Aliment Pharmacol Ther VL - 19 IS - 9 N2 - Studies using dual-energy X-ray absorptiometry have suggested a high prevalence of osteoporosis in inflammatory bowel disease. However, population-based data on fracture incidence suggest only a small increased risk of fracture amongst patients with inflammatory bowel disease compared with the general population. Therefore, it would be helpful to identify patients with inflammatory bowel disease at particularly high risk for fracture so that these risks might be modified or interventions might be undertaken. The data on calcium intake as a predictor of bone mineral density are conflicting. Although there are data suggesting that a one-time survey to determine current calcium intake will not help to predict bone mineral density in inflammatory bowel disease, persistently reduced calcium intake does appear to lead to lower bone mineral density. In the general population, body mass is strongly correlated with bone mineral density, which also appears to be true in Crohn's disease. Hence, subjects with inflammatory bowel disease and considerable weight loss, or who are obviously malnourished, could be considered for bone mineral density testing, and the finding of a low bone mineral density would suggest the need for more aggressive nutritional support. Although vitamin D is undoubtedly important in bone health, vitamin D intake and serum vitamin D levels do not correlate well with bone mineral density. Sex hormone deficiency can also adversely affect bone health, although a well-developed strategy for sex hormone measurements in patients with inflammatory bowel disease remains to be established. Ultimately, the determination of genetic mutations that accurately predict fracture susceptibility may be the best hope for developing a simplified strategy for managing bone health in inflammatory bowel disease. The therapy of osteoporosis in inflammatory bowel disease has been adapted from other osteoporosis settings, such as post-menopausal or corticosteroid-induced osteoporosis. To date, there remains no therapy proven to be efficacious in inflammatory bowel disease-related osteoporosis; however, calcium and vitamin D supplementation and bisphosphonates have their roles. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/15113361/Review_article:_Osteoporosis_and_inflammatory_bowel_disease_ L2 - https://doi.org/10.1111/j.1365-2036.2004.01876.x DB - PRIME DP - Unbound Medicine ER -