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Updated bone mineral density status in Saudi patients with inflammatory bowel disease.
World J Gastroenterol. 2020 Sep 21; 26(35):5343-5353.WJ

Abstract

BACKGROUND

Little is known about inflammatory bowel disease (IBD) burden and its impact on bone mineral density (BMD) among adult patients in Saudi Arabia. To the best of our knowledge, our study is the only study to give an update about this health problem in adult Saudi patients with IBD. IBD is a great risk factor for reduced BMD due to its associated chronic inflammation, malabsorption, weight loss and medication side effects. Consequently, screening for reduced BMD among patients with IBD is of utmost importance to curb and control anticipated morbidity and mortality among those patients.

AIM

To assess the relationship between IBD and BMD in a sample of adult Saudi patients with IBD.

METHODS

Ninety adult patients with IBD - 62 Crohn's disease (CD) and 28 ulcerative colitis (UC) - were recruited from King Fahad Specialist Hospital gastroenterology clinics in Buraidah, Al-Qassim. All enrolled patients were interviewed for their demographic information and for IBD- and BMD-related clinical data. All patients had the necessary laboratory markers and dual-energy x-ray absorptiometry scans to evaluate their BMD status. Patients were divided into two groups (CD and UC) to explore their clinical characteristics and possible risk factors for reduced BMD.

RESULTS

The CD group was significantly more prone to osteopenia and osteoporosis compared to the UC group; 44% of the CD patients had normal BMD, 19% had osteopenia, and 37% had osteoporosis, while 78% of the UC patients had normal BMD, 7% had osteopenia, and 25% had osteoporosis (P value < 0.05). In the CD group, the lowest t-score showed a statistically significant correlation with body mass index (BMI) (r = 0.45, P < 0.001), lumbar z-score (r = 0.77, P < 0.05) and femur z-score (r = 0.85, P < 0.05). In the UC group, the lowest t-score showed only statistically significant correlation with the lumbar z-score (r = 0.82, P < 0.05) and femur z-score (r = 0.80, P < 0.05). The ROC-curve showed that low BMI could predict the lowest t-score in the CD group with the best cut-off value at ≤ 23.43 (m/kg2); area under the curve was 0.73 (95%CI: 0.59-0.84), with a sensitivity of 77%, and a specificity of 63%.

CONCLUSION

Saudi patients with IBD still have an increased risk of reduced BMD, more in CD patients. Low BMI is a significant risk factor for reduced BMD in CD patients.

Authors+Show Affiliations

Internal Medicine Department, College of Medicine, Sulaiman Al Rajhi University, Bukairyah 51941, Al-Qassim, Saudi Arabia.Gastroenterology Department, King Fahad Specialist Hospital, Buraidah 52366, Al-Qassim, Saudi Arabia.Gastroenterology Department, King Fahad Specialist Hospital, Buraidah 52366, Al-Qassim, Saudi Arabia.Gastroenterology Department, King Fahad Specialist Hospital, Buraidah 52366, Al-Qassim, Saudi Arabia.Gastroenterology Department, King Fahad Specialist Hospital, Buraidah 52366, Al-Qassim, Saudi Arabia.Epidemiology Department, College of Medicine, Sulaiman Al Rajhi University, Bukairyah 51941, Al-Qassim, Saudi Arabia.Medical students, College of Medicine, Sulaiman Al Rajhi University, Bukairyah 51941, Al-Qassim, Saudi Arabia.Medical students, College of Medicine, Sulaiman Al Rajhi University, Bukairyah 51941, Al-Qassim, Saudi Arabia.Medical students, College of Medicine, Sulaiman Al Rajhi University, Bukairyah 51941, Al-Qassim, Saudi Arabia.Medical students, College of Medicine, Sulaiman Al Rajhi University, Bukairyah 51941, Al-Qassim, Saudi Arabia.Medical students, College of Medicine, Sulaiman Al Rajhi University, Bukairyah 51941, Al-Qassim, Saudi Arabia.Critical Care Medicine Department, College of Medicine, Sulaiman Al Rajhi University, Bukairyah 51941, Al-Qassim, Saudi Arabia.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32994692

Citation

Ewid, Mohammed, et al. "Updated Bone Mineral Density Status in Saudi Patients With Inflammatory Bowel Disease." World Journal of Gastroenterology, vol. 26, no. 35, 2020, pp. 5343-5353.
Ewid M, Al Mutiri N, Al Omar K, et al. Updated bone mineral density status in Saudi patients with inflammatory bowel disease. World J Gastroenterol. 2020;26(35):5343-5353.
Ewid, M., Al Mutiri, N., Al Omar, K., Shamsan, A. N., Rathore, A. A., Saquib, N., Salaas, A., Al Sarraj, O., Nasri, Y., Attal, A., Tawfiq, A., & Sherif, H. (2020). Updated bone mineral density status in Saudi patients with inflammatory bowel disease. World Journal of Gastroenterology, 26(35), 5343-5353. https://doi.org/10.3748/wjg.v26.i35.5343
Ewid M, et al. Updated Bone Mineral Density Status in Saudi Patients With Inflammatory Bowel Disease. World J Gastroenterol. 2020 Sep 21;26(35):5343-5353. PubMed PMID: 32994692.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Updated bone mineral density status in Saudi patients with inflammatory bowel disease. AU - Ewid,Mohammed, AU - Al Mutiri,Nawaf, AU - Al Omar,Khalid, AU - Shamsan,Amal N, AU - Rathore,Awais A, AU - Saquib,Nazmus, AU - Salaas,Anas, AU - Al Sarraj,Omar, AU - Nasri,Yaman, AU - Attal,Ahmed, AU - Tawfiq,Abdulrahman, AU - Sherif,Hossam, PY - 2020/05/08/received PY - 2020/06/15/revised PY - 2020/08/22/accepted PY - 2020/9/30/entrez PY - 2020/10/1/pubmed PY - 2021/5/15/medline KW - Bone mineral density KW - Crohn’s disease KW - Fracture risk KW - Inflammatory bowel disease KW - Osteoporosis KW - Ulcerative colitis SP - 5343 EP - 5353 JF - World journal of gastroenterology JO - World J Gastroenterol VL - 26 IS - 35 N2 - BACKGROUND: Little is known about inflammatory bowel disease (IBD) burden and its impact on bone mineral density (BMD) among adult patients in Saudi Arabia. To the best of our knowledge, our study is the only study to give an update about this health problem in adult Saudi patients with IBD. IBD is a great risk factor for reduced BMD due to its associated chronic inflammation, malabsorption, weight loss and medication side effects. Consequently, screening for reduced BMD among patients with IBD is of utmost importance to curb and control anticipated morbidity and mortality among those patients. AIM: To assess the relationship between IBD and BMD in a sample of adult Saudi patients with IBD. METHODS: Ninety adult patients with IBD - 62 Crohn's disease (CD) and 28 ulcerative colitis (UC) - were recruited from King Fahad Specialist Hospital gastroenterology clinics in Buraidah, Al-Qassim. All enrolled patients were interviewed for their demographic information and for IBD- and BMD-related clinical data. All patients had the necessary laboratory markers and dual-energy x-ray absorptiometry scans to evaluate their BMD status. Patients were divided into two groups (CD and UC) to explore their clinical characteristics and possible risk factors for reduced BMD. RESULTS: The CD group was significantly more prone to osteopenia and osteoporosis compared to the UC group; 44% of the CD patients had normal BMD, 19% had osteopenia, and 37% had osteoporosis, while 78% of the UC patients had normal BMD, 7% had osteopenia, and 25% had osteoporosis (P value < 0.05). In the CD group, the lowest t-score showed a statistically significant correlation with body mass index (BMI) (r = 0.45, P < 0.001), lumbar z-score (r = 0.77, P < 0.05) and femur z-score (r = 0.85, P < 0.05). In the UC group, the lowest t-score showed only statistically significant correlation with the lumbar z-score (r = 0.82, P < 0.05) and femur z-score (r = 0.80, P < 0.05). The ROC-curve showed that low BMI could predict the lowest t-score in the CD group with the best cut-off value at ≤ 23.43 (m/kg2); area under the curve was 0.73 (95%CI: 0.59-0.84), with a sensitivity of 77%, and a specificity of 63%. CONCLUSION: Saudi patients with IBD still have an increased risk of reduced BMD, more in CD patients. Low BMI is a significant risk factor for reduced BMD in CD patients. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/32994692/Updated_bone_mineral_density_status_in_Saudi_patients_with_inflammatory_bowel_disease_ L2 - https://www.wjgnet.com/1007-9327/full/v26/i35/5343.htm DB - PRIME DP - Unbound Medicine ER -