Kaya Gülfem, Koçak Erdem, Akbal Erdem, Taş Adnan, Köklü Seyfettin
Department of Endocrinology and Gastroenterology, Ankara Education and Research Hospital, Ankara, Turkey.
South Med J. 2011 Nov;104(11):747-51. doi: 10.1097/SMJ.0b013e318232367e.
Inflammatory bowel disease (IBD) is a gastrointestinal system disorder with a variety of causes. The prevalence of reduced bone mineral density (BMD) is greater in people with IBD as compared with healthy individuals. In this study, we aimed to investigate the possible risk factors for low BMD in subjects with ulcerative colitis (UC) and in healthy control subjects.
A total of 40 subjects with UC and 29 healthy subjects were enrolled in the study. Age; sex; body mass index; location and duration of disease; current corticosteroid, azathioprine, or other immunosuppressive medications; smoking; consumption of alcohol, milk, and milk products; menstrual pattern in women; and use of vitamin D, calcium, folic acid, multivitamins, and iron preparations were recorded. BMD was measured by dual-energy x-ray absorptiometry at L2-L4 of the spine and the femoral neck.
The BMD of patients was found to be lower than that in the control group. The T and z scores of the lumbar vertebra and femoral neck were normal in 21 subjects (52.5%). A total of 17 (42.5%) subjects had osteopenia, and 2 (5%) subjects had osteoporosis. Parathyroid hormone, 1,25(OH)2 vitamin D3, osteocalcin, and urinary markers were found to be similar in both groups. There were no significant differences between subjects with UC and subjects in the control group according to age, sex, and conventional risk factors.
The BMD of subjects with UC was found to be lower than that in subjects of similar age and sex in the control group. Our findings suggest that that the disease itself is the most important pathogenic factor contributing to low BMD.
炎症性肠病(IBD)是一种病因多样的胃肠系统疾病。与健康个体相比,炎症性肠病患者骨密度(BMD)降低的患病率更高。在本研究中,我们旨在调查溃疡性结肠炎(UC)患者和健康对照者骨密度降低的可能危险因素。
本研究共纳入40例UC患者和29例健康受试者。记录年龄、性别、体重指数、疾病部位和病程、当前使用的皮质类固醇、硫唑嘌呤或其他免疫抑制药物、吸烟、酒精、牛奶及奶制品的摄入量、女性的月经模式,以及维生素D、钙、叶酸、多种维生素和铁制剂的使用情况。采用双能X线吸收法测量脊柱L2-L4和股骨颈的骨密度。
发现患者的骨密度低于对照组。21名受试者(52.5%)腰椎和股骨颈的T值和z值正常。共有17名受试者(42.5%)患有骨质减少,2名受试者(5%)患有骨质疏松。发现两组甲状旁腺激素、1,25(OH)2维生素D3、骨钙素和尿标志物相似。根据年龄、性别和传统危险因素,UC患者与对照组受试者之间无显著差异。
发现UC患者的骨密度低于对照组中年龄和性别相似的受试者。我们的研究结果表明,疾病本身是导致骨密度降低的最重要致病因素。