炎症性肠病的活动如何影响骨质流失。

How activity of inflammatory bowel disease influences bone loss.

机构信息

Department of Endocrinology, Diabetes and Metabolic Diseases, Clinical Hospital Centre Rijeka, Rijeka, Croatia.

出版信息

J Clin Densitom. 2010 Jan-Mar;13(1):36-42. doi: 10.1016/j.jocd.2009.12.002.

DOI:10.1016/j.jocd.2009.12.002

PMID:20171567

Abstract

Bone loss is a common problem for individuals with inflammatory bowel disease (IBD). The aim of our study was to assess bone mineral density (BMD) in patients with IBD and to investigate the role of corticosteroid (CS) use and duration and activity of disease on BMD. Ninety-two patients (56 men and 36 women) with IBD, of whom 32 had ulcerative colitis (UC) and 60 had Crohn's disease (CD), underwent clinical assessment. Lumbar and femoral neck BMDs were measured by dual-energy X-ray absorptiometry. Osteopenia was observed in 14 patients (43%) with UC and in 24 patients (40%) with CD (p=0.187). Four patients (12%) with UC and 7 patients (11%) with CD had osteoporosis (p=0.308). Femoral BMD decreased in patients with long duration of CS use and correlated inversely with disease activity. Multiple regression analysis of BMD showed that statistically significant risk factors were duration of active disease and body mass index as well. Based on our results, it is necessary to take into account the risk of decreased BMD in patients with IBD. It is most important to achieve disease remission as soon as possible in addition to nutritional support.

摘要

骨量流失是炎症性肠病（IBD）患者的常见问题。我们的研究旨在评估 IBD 患者的骨矿物质密度（BMD），并探讨皮质类固醇（CS）使用时间、疾病活动度对 BMD 的影响。92 例 IBD 患者（56 名男性和 36 名女性）接受了临床评估。采用双能 X 线吸收法测量腰椎和股骨颈的 BMD。14 例（43%）UC 患者和 24 例（40%）CD 患者存在骨质疏松症（p=0.187）。4 例（12%）UC 患者和 7 例（11%）CD 患者患有骨质疏松症（p=0.308）。CS 使用时间长的患者股骨 BMD 降低，且与疾病活动度呈负相关。BMD 的多元回归分析显示，有统计学意义的风险因素是疾病活动的持续时间和体重指数。基于我们的研究结果，有必要考虑 IBD 患者的 BMD 降低风险。除了营养支持，最重要的是尽快实现疾病缓解。