Sapone N, Pellicano R, Simondi D, Sguazzini C, Reggiani S, Terzi E, Rizzetto M, Astegiano M
Department of Gastro-Hepatology, Molinette Hospital, Turin, Italy.
Minerva Med. 2008 Feb;99(1):65-71.
The availability of osteodensitometry has contributed significantly to increase the awareness of inflammatory bowel disease (IBD)-associated bone disease. Reported osteoporosis prevalence in patients with IBD range from 2% to 30%. The fractures risk varies between studies, influenced by demographic, clinical and genetic factors. The main pathogenetic factors involved are malabsorption, treatment with glucocorticoids, inflammation (increased cytokine production) and hypogonadism. A screening should be considered for all patients with small bowel Crohn's disease and especially for those with extensive disease, multiple resections, and malnutrition. Supplementation with both calcium and vitamin D is frequently the first step taken, but is insufficient to inhibit bone loss in many patients requiring use of glucocorticoids. Among available therapies, only biphosphonates are effective for treatment of glucocorticoid-induced osteoporosis.
骨密度测定技术的应用显著提高了人们对炎症性肠病（IBD）相关骨病的认识。IBD患者中报道的骨质疏松患病率在2%至30%之间。不同研究中骨折风险有所不同，受人口统计学、临床和遗传因素影响。主要涉及的发病因素有吸收不良、糖皮质激素治疗、炎症（细胞因子产生增加）和性腺功能减退。对于所有小肠克罗恩病患者，尤其是那些患有广泛性疾病、多次手术和营养不良的患者，应考虑进行筛查。补充钙和维生素D通常是首先采取的措施，但对于许多需要使用糖皮质激素的患者来说，这不足以抑制骨质流失。在现有的治疗方法中，只有双膦酸盐对治疗糖皮质激素诱导的骨质疏松有效。
