Katz Seymour
New York University School of Medicine, New York, NY, USA.
Rev Gastroenterol Disord. 2006 Spring;6(2):63-71.
Patients with inflammatory bowel disease (IBD) are at increased risk for osteoporotic fracture. Bone density testing and osteoporosis management are recommended for IBD patients at greater risk for fracture (ie, postmenopausal women, men aged . 60 years, and those with low body mass indices, glucocorticoid use, family history of osteoporosis, and malabsorption). Patient management includes modification of osteoporosis risk factors, such as calcium and vitamin D supplementation, hormone deficiency correction, and smoking cessation. When indicated, bisphosphonates, such as risedronate and alendronate, have been shown to increase bone mass and reduce fracture risk in patients with glucocorticoid-induced osteoporosis. Infliximab, an anti-tumor necrosis factor a antibody, increases bone mineral density, but this effect has not as yet translated into reduced fracture risk.
炎症性肠病（IBD）患者发生骨质疏松性骨折的风险增加。对于骨折风险较高的IBD患者（即绝经后女性、60岁以上男性以及体重指数较低、使用糖皮质激素、有骨质疏松家族史和吸收不良的患者），建议进行骨密度检测和骨质疏松管理。患者管理包括改变骨质疏松风险因素，如补充钙和维生素D、纠正激素缺乏以及戒烟。在有指征时，已证明双膦酸盐类药物，如利塞膦酸盐和阿仑膦酸盐，可增加糖皮质激素诱导的骨质疏松患者的骨量并降低骨折风险。英夫利昔单抗，一种抗肿瘤坏死因子α抗体，可增加骨矿物质密度，但这种作用尚未转化为降低骨折风险。
