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[炎症性肠病患者低骨矿物质密度的危险因素]

[The risk factor for low bone mineral density in patients with inflammatory bowel disease].

作者信息

Liu Jian-bin, Gao Xiang, Zhang Fang-bin, Yang Li, Xiao Ying-lian, Zhang Rui-dong, Li Zi-ping, Hu Pin-jin, Chen Min-hu

机构信息

Department of Gastroenterology, Sun Yat-Sen University, Guangzhou 510080, China.

出版信息

Zhonghua Nei Ke Za Zhi. 2009 Oct;48(10):833-6.

Abstract

OBJECTIVE

To evaluate the prevalence of low bone mineral density in patients with inflammatory bowel disease (IBD)and to identify its risk factors.

METHODS

A cross-sectional survey was carried out in IBD patients. Anthropometric measures, biochemical markers of nutrition and bone mineral density measurement were completed for these patients as well as healthy control subjects.

RESULTS

Seventy-seven Crohn's disease (CD) and 43 ulcerative colitis (UC) patients were enrolled, and 37 healthy volunteers were recruited as healthy controls (HC). The T value of CD patients, UC patients and HC was -1.72 +/- 1.20, -1.26 +/- 1.12 and -0.62 +/- 0.87 respectively and the T value of CD patients was significantly lower than that of HC (P = 0.000). The prevalence of osteoporosis in CD, UC and HC was 23.3%, 14.0% and 0 respectively. The prevalence of osteoporosis in CD was higher than that in HC (P = 0.003). Logistic regression analysis indicated that low BMI (BMI < or = 18.4 kg/m(2)) was an independent risk factor for osteoporosis both in CD (OR = 11.25, 95%CI 3.198 - 39.580, P = 0.000) and in UC (OR = 14.50, 95%CI 1.058 - 88.200, P = 0.045) patients. Age, disease duration, clinical activity active index (CDAI), oral steroid therapy, immunosuppressant treatment and serum vitamin D concentration were not found to be correlated with osteoporosis in IBD patients.

CONCLUSIONS

Low bone mineral density is common in both CD and UC patients and low BMI is an independent risk factor for osteoporosis in IBD patients.

摘要

目的

评估炎症性肠病(IBD)患者低骨密度的患病率,并确定其危险因素。

方法

对IBD患者进行横断面调查。对这些患者以及健康对照者完成人体测量、营养生化指标检测和骨密度测量。

结果

纳入77例克罗恩病(CD)患者和43例溃疡性结肠炎(UC)患者,并招募37名健康志愿者作为健康对照(HC)。CD患者、UC患者和HC的T值分别为-1.72±1.20、-1.26±1.12和-0.62±0.87,CD患者的T值显著低于HC(P = 0.000)。CD、UC和HC的骨质疏松患病率分别为23.3%、14.0%和0。CD的骨质疏松患病率高于HC(P = 0.003)。逻辑回归分析表明,低体重指数(BMI≤18.4 kg/m²)是CD患者(OR = 11.25,95%CI 3.198 - 39.580,P = 0.000)和UC患者(OR = 14.50,95%CI 1.058 - 88.200,P = 0.045)骨质疏松的独立危险因素。在IBD患者中,年龄、病程、临床活动度(CDAI)、口服类固醇治疗、免疫抑制剂治疗和血清维生素D浓度与骨质疏松无相关性。

结论

低骨密度在CD和UC患者中均很常见,低BMI是IBD患者骨质疏松的独立危险因素。

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