Crohn's disease and risk of fracture: does thyroid disease play a role?

To assess the role of thyroid disease as a risk for fractures in Crohn's patients.

A cross-sectional study was conducted from 1998 to 2000. The study group consisted of 210 patients with Crohn's disease. A group of 206 patients without inflammatory bowel disease served as controls. Primary outcome was thyroid disorder. Secondary outcomes included use of steroids, immunosuppressive medications, surgery and incidence of fracture.

The prevalence of hyperthyroidism was similar in both groups. However, the prevalence of hypothyroidism was lower in Crohn's patients (3.8 % vs 8.2 %, P=0.05). Within the Crohn's group, the use of immunosuppressive agents (0 % vs 11 %), steroid usage (12.5 % vs 37 %), small bowel surgery (12.5 % vs 28 %) and large bowel surgery (12.5 % vs 27 %) were lower in the hypothyroid subset as compared to the euthyroid subset. Seven (3.4 %) Crohn's patients suffered fracture, all of whom were euthyroid.

Thyroid disorder was not found to be associated with Crohn's disease and was not found to increase the risk for fractures. Therefore, screening for thyroid disease is not a necessary component in the management of Crohn's disease.