de Silva Arjuna Priyadarsin, Karunanayake Aranjan Lionel, Dissanayaka Thalahitiya Gamaralalage Iruka, Dassanayake Anuradha Supun, Duminda Hewa Kattadi Kankanamgae Tilak, Pathmeswaran Arunasalam, Wickramasinghe Ananda Rajitha, de Silva Hithanadura Janaka
Department of Medicine, Faculty of Medicine, University of Kelaniya, PO Box 6, Thalagolla Road, Ragama GQ11010, Sri Lanka.
World J Gastroenterol. 2009 Jul 28;15(28):3528-31. doi: 10.3748/wjg.15.3528.
To determine if inflammatory bowel disease (IBD) is a risk factor for osteoporosis in adult Sri Lankans.
We identified eligible subjects from among consecutive patients diagnosed with IBD who attended our outpatient clinic. We included only patients aged between 20 and 70 years. Patients who were pregnant, had significant comorbidity, or were on calcium supplements or treatment for osteoporosis within the past 6 mo, were excluded. Healthy, age- and sex-matched controls were also recruited, in a control to patient ratio of 3:1. Both groups were screened for osteoporosis using peripheral dual energy X-ray absorptiometry scanning.
The study population consisted of 111 IBD patients (male:female = 43:68; mean age 42.5 years) and 333 controls (male:female = 129:204; mean age 43.8 years). The occurrence of osteoporosis among IBD patients (13.5%) was significantly higher than among controls (4.5%) (P = 0.001). The frequency of osteoporosis was not significantly different between ulcerative colitis (14.45%) and Crohn's disease (10.7%). However, on multivariate analysis, only age (P = 0.001), menopause (P = 0.024) and use of systemic steroids (P < 0.001) were found to be associated independently with the occurrence of osteoporosis, while IBD, severity of disease, number of relapses, duration of illness or treatment other than systemic steroids were not.
IBD does not appear to be an independent risk factor for the occurrence of osteoporosis in this population. However, the use of systemic steroids was a risk factor.
确定炎症性肠病(IBD)是否为成年斯里兰卡人骨质疏松症的危险因素。
我们从连续就诊于我院门诊并被诊断为IBD的患者中确定符合条件的受试者。仅纳入年龄在20至70岁之间的患者。排除怀孕、有严重合并症或在过去6个月内服用钙补充剂或接受骨质疏松症治疗的患者。还招募了年龄和性别匹配的健康对照,对照与患者的比例为3:1。两组均采用外周双能X线吸收法扫描筛查骨质疏松症。
研究人群包括111例IBD患者(男:女 = 43:68;平均年龄42.5岁)和333例对照(男:女 = 129:204;平均年龄43.8岁)。IBD患者中骨质疏松症的发生率(13.5%)显著高于对照组(4.5%)(P = 0.001)。溃疡性结肠炎(14.45%)和克罗恩病(10.7%)之间骨质疏松症的发生率无显著差异。然而,多因素分析显示,仅年龄(P = 0.001)、绝经(P = 0.024)和全身用类固醇的使用(P < 0.001)与骨质疏松症的发生独立相关,而IBD、疾病严重程度、复发次数、病程或全身用类固醇以外的治疗则无关。
在该人群中,IBD似乎不是骨质疏松症发生的独立危险因素。然而,全身用类固醇的使用是一个危险因素。