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Evolution of osteopenia in inflammatory bowel disease
1Dipartimento di Scienze Chirurgiche e Gastroenterologiche, and Istituto di Semeiotica, Università, di Padova, Italy.
The American Journal of Gastroenterology
|May 11, 1999
Summary
Osteopenia is common in inflammatory bowel disease (IBD). While bone mineral density (BMD) is stable in Crohn's disease (CD), it declines in ulcerative colitis (UC), possibly due to corticosteroid side effects.
Area of Science:
- Gastroenterology and Hepatology
- Endocrinology
- Rheumatology
Background:
- Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), is associated with various extraintestinal manifestations, including bone density loss.
- Osteopenia and osteoporosis are significant concerns in IBD patients, potentially leading to increased fracture risk.
Purpose of the Study:
- To assess the frequency and progression of osteopenia in patients with IBD.
- To identify factors associated with bone density changes in CD and UC.
Main Methods:
- Bone mineral density (BMD) of the lumbar spine was measured in 54 CD and 49 UC patients, with follow-up measurements in a subset.
- Serum biochemistry, including minerals and inflammation markers, was assessed.
- Controls included 18 age-matched healthy subjects.
Main Results:
- Reduced BMD was observed in 48% of CD and 38% of UC patients, significantly lower than controls.
- BMD correlated positively with body mass index and inversely with lifetime steroid dose.
- Over 21 months, BMD remained stable in CD patients but significantly decreased in UC patients, likely due to steroid treatment.
Conclusions:
- Low bone density is prevalent in both CD and UC.
- In CD, osteopenia appears linked to the disease pathogenesis and is relatively stable.
- In UC, bone density loss seems associated with corticosteroid treatment side effects.