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Prevalence and pathogenesis of osteoporosis in patients with inflammatory bowel disease.
Minerva Med. 2004 Dec; 95(6):469-80.MM

Abstract

Decreased bone mineral density is a frequent finding in patients with inflammatory bowel disease. Factors contributing to this are: 1) malabsorption of vitamin D, calcium and possibly vitamin K and other nutrients, 2) treatment with corticosteroids, 3) inflammatory cytokines in inflammatory bowel disease, and 4) hypogonadism induced by the inflammatory bowel disease. Among patients with Crohn's disease from 32% to 38% have osteopenia (Z-scores <-1), and among patients with ulcerative colitis 23% to 25% have osteopenia. The mean deficit was 0.44+/-0.08 Z-scores in the spine in Crohn's disease and 0.34+/-0.08 in ulcerative colitis. A similar deficit was seen in the hip in both conditions. From these deficits, an increase in overall fracture risk of 1.1-1.3 should be expected. The observed excess fracture risk was limited compared to the general population in both Crohn's disease (RR=1.2, 95% CI: 0.9-1.6 for any fracture and 2.2, 95% CI: 1.2-4.0 for spine fractures) and ulcerative colitis (RR=1.1, 95% CI: 1-1.2 for any fracture, and 1.5, 95% CI: 0.9-2.5 for spine fractures). The observed excess fracture risk was close to that expected from the changes in BMD. Despite the limited excess fracture risk, a relatively large percentage of all fractures may be attributable to corticosteroid use among users of corticosteroids.

Authors+Show Affiliations

The Osteoporosis Clinic, Aarhus Amtssygehus, Aarhus University Hospital, Aarhus, Denmark. p-vest@post4.tele.dk

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

15785432

Citation

Vestergaard, P. "Prevalence and Pathogenesis of Osteoporosis in Patients With Inflammatory Bowel Disease." Minerva Medica, vol. 95, no. 6, 2004, pp. 469-80.
Vestergaard P. Prevalence and pathogenesis of osteoporosis in patients with inflammatory bowel disease. Minerva Med. 2004;95(6):469-80.
Vestergaard, P. (2004). Prevalence and pathogenesis of osteoporosis in patients with inflammatory bowel disease. Minerva Medica, 95(6), 469-80.
Vestergaard P. Prevalence and Pathogenesis of Osteoporosis in Patients With Inflammatory Bowel Disease. Minerva Med. 2004;95(6):469-80. PubMed PMID: 15785432.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevalence and pathogenesis of osteoporosis in patients with inflammatory bowel disease. A1 - Vestergaard,P, PY - 2005/3/24/pubmed PY - 2005/5/20/medline PY - 2005/3/24/entrez SP - 469 EP - 80 JF - Minerva medica JO - Minerva Med VL - 95 IS - 6 N2 - Decreased bone mineral density is a frequent finding in patients with inflammatory bowel disease. Factors contributing to this are: 1) malabsorption of vitamin D, calcium and possibly vitamin K and other nutrients, 2) treatment with corticosteroids, 3) inflammatory cytokines in inflammatory bowel disease, and 4) hypogonadism induced by the inflammatory bowel disease. Among patients with Crohn's disease from 32% to 38% have osteopenia (Z-scores <-1), and among patients with ulcerative colitis 23% to 25% have osteopenia. The mean deficit was 0.44+/-0.08 Z-scores in the spine in Crohn's disease and 0.34+/-0.08 in ulcerative colitis. A similar deficit was seen in the hip in both conditions. From these deficits, an increase in overall fracture risk of 1.1-1.3 should be expected. The observed excess fracture risk was limited compared to the general population in both Crohn's disease (RR=1.2, 95% CI: 0.9-1.6 for any fracture and 2.2, 95% CI: 1.2-4.0 for spine fractures) and ulcerative colitis (RR=1.1, 95% CI: 1-1.2 for any fracture, and 1.5, 95% CI: 0.9-2.5 for spine fractures). The observed excess fracture risk was close to that expected from the changes in BMD. Despite the limited excess fracture risk, a relatively large percentage of all fractures may be attributable to corticosteroid use among users of corticosteroids. SN - 0026-4806 UR - https://www.unboundmedicine.com/medline/citation/15785432/Prevalence_and_pathogenesis_of_osteoporosis_in_patients_with_inflammatory_bowel_disease_ DB - PRIME DP - Unbound Medicine ER -