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Risk factors for decreased bone mineral density in inflammatory bowel disease: A cross-sectional study.
Clin Nutr. 2015 Dec; 34(6):1202-9.CN

Abstract

BACKGROUND & AIM

Although inflammatory bowel disease (IBD) patients are at risk for metabolic bone disease, studies analyzing this correlation have identified various risk factors, including disease phenotype, age, sex and steroid therapy. Furthermore, few studies have assessed risk factors for bone loss in Japanese IBD patients. This study analyzed risk factors for metabolic bone disease in Japanese IBD patients.

METHODS

This cross-sectional study assessed 388 patients with IBD aged 20-50 years, including 232 with ulcerative colitis (UC) and 156 with Crohn's disease (CD). Bone mineral density of the femoral neck, total femur and lumbar spine was quantified by dual-energy X-ray absorptiometry. The blood concentrations of bone metabolism markers were measured. History of smoking and bone fracture, and nutritional intake were assessed using questionnaires.

RESULTS

Of the 388 patients with IBD, 78 (20.1%; UC, 17.2%; CD, 24.4%) had osteopenia and 17 (4.4%; UC, 3.4%; CD, 5.8%) had osteoporosis, as assessed by T-score. Bone mineral density of the lumbar vertebrae was lower in males than in females. Multivariate regression analysis showed that risk factors for bone loss in UC patients were male sex, low body mass index (BMI), high steroid dose and disease location. Risk factors for bone loss in CD patients were male sex and low BMI.

CONCLUSION

Among Japanese patients with IBD, male sex and low BMI were associated with increased risk for metabolic bone disease. In addition, Steroid therapy shouldn't be indiscriminate in UC patients. These findings may help identify patients at particularly high risk of metabolic bone disease and may help implement appropriate therapies in a timely manner and improve long-term quality of life.

Authors+Show Affiliations

Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan; Center for Human Nutrition, The University of Texas Southwestern Medical Center, Dallas, TX, USA.Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan. Electronic address: hisamachi@a7.keio.jp.Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, Japan.Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, Japan.Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.Center for Clinical Research, School of Medicine, Keio University, Tokyo, Japan.Center for Preventive Medicine, School of Medicine, Keio University, Tokyo, Japan.Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University, Tokyo, Japan.Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan.Center for Clinical Research, School of Medicine, Keio University, Tokyo, Japan.Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25618799

Citation

Wada, Yasuyo, et al. "Risk Factors for Decreased Bone Mineral Density in Inflammatory Bowel Disease: a Cross-sectional Study." Clinical Nutrition (Edinburgh, Scotland), vol. 34, no. 6, 2015, pp. 1202-9.
Wada Y, Hisamatsu T, Naganuma M, et al. Risk factors for decreased bone mineral density in inflammatory bowel disease: A cross-sectional study. Clin Nutr. 2015;34(6):1202-9.
Wada, Y., Hisamatsu, T., Naganuma, M., Matsuoka, K., Okamoto, S., Inoue, N., Yajima, T., Kouyama, K., Iwao, Y., Ogata, H., Hibi, T., Abe, T., & Kanai, T. (2015). Risk factors for decreased bone mineral density in inflammatory bowel disease: A cross-sectional study. Clinical Nutrition (Edinburgh, Scotland), 34(6), 1202-9. https://doi.org/10.1016/j.clnu.2015.01.003
Wada Y, et al. Risk Factors for Decreased Bone Mineral Density in Inflammatory Bowel Disease: a Cross-sectional Study. Clin Nutr. 2015;34(6):1202-9. PubMed PMID: 25618799.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for decreased bone mineral density in inflammatory bowel disease: A cross-sectional study. AU - Wada,Yasuyo, AU - Hisamatsu,Tadakazu, AU - Naganuma,Makoto, AU - Matsuoka,Katsuyoshi, AU - Okamoto,Susumu, AU - Inoue,Nagamu, AU - Yajima,Tomoharu, AU - Kouyama,Keisuke, AU - Iwao,Yasushi, AU - Ogata,Haruhiko, AU - Hibi,Toshifumi, AU - Abe,Takayuki, AU - Kanai,Takanori, Y1 - 2015/01/13/ PY - 2014/06/04/received PY - 2014/12/29/revised PY - 2015/01/04/accepted PY - 2015/1/26/entrez PY - 2015/1/27/pubmed PY - 2016/9/30/medline KW - Body mass index KW - Crohn's disease KW - Inflammatory bowel disease KW - Japanese KW - Osteoporosis KW - Ulcerative colitis SP - 1202 EP - 9 JF - Clinical nutrition (Edinburgh, Scotland) JO - Clin Nutr VL - 34 IS - 6 N2 - BACKGROUND & AIM: Although inflammatory bowel disease (IBD) patients are at risk for metabolic bone disease, studies analyzing this correlation have identified various risk factors, including disease phenotype, age, sex and steroid therapy. Furthermore, few studies have assessed risk factors for bone loss in Japanese IBD patients. This study analyzed risk factors for metabolic bone disease in Japanese IBD patients. METHODS: This cross-sectional study assessed 388 patients with IBD aged 20-50 years, including 232 with ulcerative colitis (UC) and 156 with Crohn's disease (CD). Bone mineral density of the femoral neck, total femur and lumbar spine was quantified by dual-energy X-ray absorptiometry. The blood concentrations of bone metabolism markers were measured. History of smoking and bone fracture, and nutritional intake were assessed using questionnaires. RESULTS: Of the 388 patients with IBD, 78 (20.1%; UC, 17.2%; CD, 24.4%) had osteopenia and 17 (4.4%; UC, 3.4%; CD, 5.8%) had osteoporosis, as assessed by T-score. Bone mineral density of the lumbar vertebrae was lower in males than in females. Multivariate regression analysis showed that risk factors for bone loss in UC patients were male sex, low body mass index (BMI), high steroid dose and disease location. Risk factors for bone loss in CD patients were male sex and low BMI. CONCLUSION: Among Japanese patients with IBD, male sex and low BMI were associated with increased risk for metabolic bone disease. In addition, Steroid therapy shouldn't be indiscriminate in UC patients. These findings may help identify patients at particularly high risk of metabolic bone disease and may help implement appropriate therapies in a timely manner and improve long-term quality of life. SN - 1532-1983 UR - https://www.unboundmedicine.com/medline/citation/25618799/Risk_factors_for_decreased_bone_mineral_density_in_inflammatory_bowel_disease:_A_cross_sectional_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0261-5614(15)00008-4 DB - PRIME DP - Unbound Medicine ER -