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The frequency of low bone mineral density and its associated risk factors in patients with inflammatory bowel diseases.

Abstract

OBJECTIVE

To detect the frequency and the predictive factors of low bone mineral density in inflammatory bowel disease (IBD) patients, so as to optimize bone mineral density (BMD) monitoring and treatment for those at risk.

SUBJECTS AND METHODS

Thirty Asian patients were included in this study and were divided into 18 patients with ulcerative colitis (UC), and 12 patients with Crohn's disease (CD). All patients were diagnosed by colonoscopy and histopathological biopsy and were subjected to routine laboratory investigations in addition to 25 hydroxy vitamin D levels as well as serum calcium, phosphorus and alkaline phosphatise. BMD was measured by using dual-energy X-ray absorptiometry (DEXA) scan at lumbar spine and femoral neck; predictive factors for BMD were analyzed by group comparison and step-wise regression analysis.

RESULTS

There was increased frequency of osteoporosis and osteopenia involving the lumbar spine in patients with IBD being more common among CD patients than in the UC group. Positive correlations were found between low BMD measurements and vitamin D levels, body mass index (BMI) (P < 0.001) as well as steroid cumulative dose and duration of therapy (P < 0.001); stepwise regression analysis showed that CD and vitamin D deficiency are predictive factors for both osteoporosis and osteopenia (P = 0.024, P = 0.027, respectively).

CONCLUSION

Low BMD was found to be more frequent among patients with CD than UC; in addition CD and vitamin D deficiency act as predictive factors for low BMD. We recommend that calcium and vitamin D should be given to all IBD patients; in addition, bisphosphonate administration should be put into consideration.

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  • Authors+Show Affiliations

    ,

    Department of Rheumatology, Al-Fayoum University, Cairo, Egypt. Yasser_ezzat74@yahoo.com

    Source

    MeSH

    Absorptiometry, Photon
    Adult
    Aged
    Alkaline Phosphatase
    Asian Continental Ancestry Group
    Biomarkers
    Biopsy
    Bone Density
    Bone Diseases, Metabolic
    Calcium
    Colitis, Ulcerative
    Colonoscopy
    Crohn Disease
    Egypt
    Female
    Femur Neck
    Fractures, Bone
    Humans
    Logistic Models
    Lumbar Vertebrae
    Male
    Middle Aged
    Osteoporosis
    Phosphorus
    Risk Assessment
    Risk Factors
    Vitamin D
    Young Adult

    Pub Type(s)

    Comparative Study
    Journal Article

    Language

    eng

    PubMed ID

    20704624

    Citation

    Ezzat, Yasser, and Khaled Hamdy. "The Frequency of Low Bone Mineral Density and Its Associated Risk Factors in Patients With Inflammatory Bowel Diseases." International Journal of Rheumatic Diseases, vol. 13, no. 3, 2010, pp. 259-65.
    Ezzat Y, Hamdy K. The frequency of low bone mineral density and its associated risk factors in patients with inflammatory bowel diseases. Int J Rheum Dis. 2010;13(3):259-65.
    Ezzat, Y., & Hamdy, K. (2010). The frequency of low bone mineral density and its associated risk factors in patients with inflammatory bowel diseases. International Journal of Rheumatic Diseases, 13(3), pp. 259-65. doi:10.1111/j.1756-185X.2010.01542.x.
    Ezzat Y, Hamdy K. The Frequency of Low Bone Mineral Density and Its Associated Risk Factors in Patients With Inflammatory Bowel Diseases. Int J Rheum Dis. 2010;13(3):259-65. PubMed PMID: 20704624.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - The frequency of low bone mineral density and its associated risk factors in patients with inflammatory bowel diseases. AU - Ezzat,Yasser, AU - Hamdy,Khaled, PY - 2010/8/14/entrez PY - 2010/8/14/pubmed PY - 2010/12/14/medline SP - 259 EP - 65 JF - International journal of rheumatic diseases JO - Int J Rheum Dis VL - 13 IS - 3 N2 - OBJECTIVE: To detect the frequency and the predictive factors of low bone mineral density in inflammatory bowel disease (IBD) patients, so as to optimize bone mineral density (BMD) monitoring and treatment for those at risk. SUBJECTS AND METHODS: Thirty Asian patients were included in this study and were divided into 18 patients with ulcerative colitis (UC), and 12 patients with Crohn's disease (CD). All patients were diagnosed by colonoscopy and histopathological biopsy and were subjected to routine laboratory investigations in addition to 25 hydroxy vitamin D levels as well as serum calcium, phosphorus and alkaline phosphatise. BMD was measured by using dual-energy X-ray absorptiometry (DEXA) scan at lumbar spine and femoral neck; predictive factors for BMD were analyzed by group comparison and step-wise regression analysis. RESULTS: There was increased frequency of osteoporosis and osteopenia involving the lumbar spine in patients with IBD being more common among CD patients than in the UC group. Positive correlations were found between low BMD measurements and vitamin D levels, body mass index (BMI) (P < 0.001) as well as steroid cumulative dose and duration of therapy (P < 0.001); stepwise regression analysis showed that CD and vitamin D deficiency are predictive factors for both osteoporosis and osteopenia (P = 0.024, P = 0.027, respectively). CONCLUSION: Low BMD was found to be more frequent among patients with CD than UC; in addition CD and vitamin D deficiency act as predictive factors for low BMD. We recommend that calcium and vitamin D should be given to all IBD patients; in addition, bisphosphonate administration should be put into consideration. SN - 1756-185X UR - https://www.unboundmedicine.com/medline/citation/20704624/The_frequency_of_low_bone_mineral_density_and_its_associated_risk_factors_in_patients_with_inflammatory_bowel_diseases_ L2 - https://doi.org/10.1111/j.1756-185X.2010.01542.x DB - PRIME DP - Unbound Medicine ER -