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Systematic review of the prevalence and development of osteoporosis or low bone mineral density and its risk factors in patients with inflammatory bowel disease.
World J Gastroenterol. 2020 Sep 21; 26(35):5362-5374.WJ

Abstract

BACKGROUND

The inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC) are chronic, immune-mediated disorders of the digestive tract. IBD is considered to be a risk factor for developing osteoporosis; however current literature on this matter is inconsistent.

AIM

To assess prevalence and development of osteoporosis and low bone mineral density (BMD), and its risk factors, in IBD patients.

METHODS

Systematic review of population-based studies. Studies were identified by electronic (January 2018) and manual searches (May 2018). Databases searched included EMBASE and PubMed and abstracts from 2014-2018 presented at the United European Gastroenterology Week, the European Crohn's and Colitis Organisation congress, and Digestive Disease Week were screened. Studies were eligible for inclusion if they investigated either the prevalence of osteoporosis or osteopenia and/or risk factors for osteoporosis or low BMD in IBD patients. Studies on children under the age of 18 were excluded. Only population-based studies were included. All risk factors for osteoporosis and low BMD investigated in any included article were considered. Study quality and the possibility of bias were analysed using the Newcastle-Ottawa scale.

RESULTS

Twelve studies including 3661 IBD patients and 12789 healthy controls were included. Prevalence of osteoporosis varied between 4%-9% in studies including both CD and UC patients; 2%-9% in studies including UC patients, and 7%-15% in studies including CD patients. Among healthy controls, prevalence of osteoporosis was 3% and 10% in two studies. CD diagnosis, lower body mass index (BMI), and lower body weight were risk factors associated with osteoporosis or low BMD. Findings regarding gender showed inconsistent results. CD patients had an increased risk for osteoporosis or low BMD over time, while UC patients did not. Increased age was associated with decreased BMD, and there was a positive association between weight and BMI and BMD over time. Great heterogeneity was found in the included studies in terms of study methodologies, definitions and the assessment of osteoporosis, and only a small number of population-based studies was available.

CONCLUSION

This systematic review found a possible increase of prevalence of osteoporosis in CD cohorts when compared to UC and cohorts including both disease types. Lower weight and lower BMI were predictors of osteoporosis or low BMD in IBD patients. The results varied considerably between studies.

Authors+Show Affiliations

Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark. sofiakarnsund@hotmail.com.Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark.Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark.Department of Endocrinology, Copenhagen University Hospital Herlev, Herlev 4600, Denmark.Gastrounit, Medical Division, Copenhagen University Hospital Hvidovre, Hvidovre 2650, Denmark.

Pub Type(s)

Journal Article
Systematic Review

Language

eng

PubMed ID

32994694

Citation

Kärnsund, Sofia, et al. "Systematic Review of the Prevalence and Development of Osteoporosis or Low Bone Mineral Density and Its Risk Factors in Patients With Inflammatory Bowel Disease." World Journal of Gastroenterology, vol. 26, no. 35, 2020, pp. 5362-5374.
Kärnsund S, Lo B, Bendtsen F, et al. Systematic review of the prevalence and development of osteoporosis or low bone mineral density and its risk factors in patients with inflammatory bowel disease. World J Gastroenterol. 2020;26(35):5362-5374.
Kärnsund, S., Lo, B., Bendtsen, F., Holm, J., & Burisch, J. (2020). Systematic review of the prevalence and development of osteoporosis or low bone mineral density and its risk factors in patients with inflammatory bowel disease. World Journal of Gastroenterology, 26(35), 5362-5374. https://doi.org/10.3748/wjg.v26.i35.5362
Kärnsund S, et al. Systematic Review of the Prevalence and Development of Osteoporosis or Low Bone Mineral Density and Its Risk Factors in Patients With Inflammatory Bowel Disease. World J Gastroenterol. 2020 Sep 21;26(35):5362-5374. PubMed PMID: 32994694.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Systematic review of the prevalence and development of osteoporosis or low bone mineral density and its risk factors in patients with inflammatory bowel disease. AU - Kärnsund,Sofia, AU - Lo,Bobby, AU - Bendtsen,Flemming, AU - Holm,Jakob, AU - Burisch,Johan, PY - 2020/03/28/received PY - 2020/05/04/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 - Epidemiology KW - Inflammatory bowel disease KW - Osteoporosis KW - Systematic review SP - 5362 EP - 5374 JF - World journal of gastroenterology JO - World J Gastroenterol VL - 26 IS - 35 N2 - BACKGROUND: The inflammatory bowel diseases (IBD), Crohn's disease (CD) and ulcerative colitis (UC) are chronic, immune-mediated disorders of the digestive tract. IBD is considered to be a risk factor for developing osteoporosis; however current literature on this matter is inconsistent. AIM: To assess prevalence and development of osteoporosis and low bone mineral density (BMD), and its risk factors, in IBD patients. METHODS: Systematic review of population-based studies. Studies were identified by electronic (January 2018) and manual searches (May 2018). Databases searched included EMBASE and PubMed and abstracts from 2014-2018 presented at the United European Gastroenterology Week, the European Crohn's and Colitis Organisation congress, and Digestive Disease Week were screened. Studies were eligible for inclusion if they investigated either the prevalence of osteoporosis or osteopenia and/or risk factors for osteoporosis or low BMD in IBD patients. Studies on children under the age of 18 were excluded. Only population-based studies were included. All risk factors for osteoporosis and low BMD investigated in any included article were considered. Study quality and the possibility of bias were analysed using the Newcastle-Ottawa scale. RESULTS: Twelve studies including 3661 IBD patients and 12789 healthy controls were included. Prevalence of osteoporosis varied between 4%-9% in studies including both CD and UC patients; 2%-9% in studies including UC patients, and 7%-15% in studies including CD patients. Among healthy controls, prevalence of osteoporosis was 3% and 10% in two studies. CD diagnosis, lower body mass index (BMI), and lower body weight were risk factors associated with osteoporosis or low BMD. Findings regarding gender showed inconsistent results. CD patients had an increased risk for osteoporosis or low BMD over time, while UC patients did not. Increased age was associated with decreased BMD, and there was a positive association between weight and BMI and BMD over time. Great heterogeneity was found in the included studies in terms of study methodologies, definitions and the assessment of osteoporosis, and only a small number of population-based studies was available. CONCLUSION: This systematic review found a possible increase of prevalence of osteoporosis in CD cohorts when compared to UC and cohorts including both disease types. Lower weight and lower BMI were predictors of osteoporosis or low BMD in IBD patients. The results varied considerably between studies. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/32994694/Systematic_review_of_the_prevalence_and_development_of_osteoporosis_or_low_bone_mineral_density_and_its_risk_factors_in_patients_with_inflammatory_bowel_disease_ L2 - https://www.wjgnet.com/1007-9327/full/v26/i35/5362.htm DB - PRIME DP - Unbound Medicine ER -