Koutroubakis Ioannis E, Zavos Christos, Damilakis John, Papadakis Georgios Z, Neratzoulakis John, Karkavitsas Nikolaos, Kouroumalis Elias A
Departments of Gastroenterology (Ioannis E. Koutroubakis, Christos Zavos, Elias A. Kouroumalis).
Medical Physics (John Damilakis).
Ann Gastroenterol. 2011;24(1):41-46.
A high prevalence of osteopenia and osteoporosis is observed in patients with inflammatory bowel disease (IBD). Various risk factors of bone loss have been suggested in IBD. The aim of the present study was to investigate the prevalence of low bone mineral density (BMD) and to identify related risk factors in Greek patients with IBD.
One hundred and eighteen consecutive IBD patients were included. All patients underwent bone densitometry by dual energy X-ray absorptiometry at the femoral neck and lumbar spine levels. Serum levels of 25 hydroxyvitamin D (25 OH D), 1.25 dihydroxyvitamin D (1.25 OH 2D), osteocalcin, calcitonin and homocysteine were measured in all participants.
Forty (33.9%) patients were normal, 55 (46.6%) were osteopenic, and 23 (19.5%) were osteoporotic. No significant differences between IBD patients with osteopenia or osteoporosis and those with normal BMD concerning the use of steroids and the examined biochemical markers were found. Statistically significant differences among the three groups were found for body mass index (BMI), age and disease duration (P=0.002, P<0.0001 and P=0.03 respectively). Multivariate analysis revealed that the most significant factors associated with BMD were age and BMI (P<0.0001). A weak but statistically significant correlation was also found for disease duration (P=0.04).
There is a high prevalence of osteopenia and osteoporosis in Greek patients with IBD. Low BMI, age and disease duration are the most important independent risk factors for osteoporosis in Greek IBD patients.
炎症性肠病（IBD）患者中骨质疏松症和骨质减少症的患病率较高。IBD中已提出了各种骨质流失的危险因素。本研究的目的是调查希腊IBD患者低骨矿物质密度（BMD）的患病率，并确定相关危险因素。
纳入118例连续的IBD患者。所有患者均在股骨颈和腰椎水平通过双能X线吸收法进行骨密度测定。对所有参与者测量血清25羟维生素D（25 OH D）、1,25二羟维生素D（1,25 OH 2D）、骨钙素、降钙素和同型半胱氨酸水平。
40例（33.9%）患者正常，55例（46.6%）骨质减少，23例（19.5%）骨质疏松。在使用类固醇和所检测的生化标志物方面，骨质减少或骨质疏松的IBD患者与BMD正常的患者之间未发现显著差异。三组之间在体重指数（BMI）、年龄和病程方面存在统计学显著差异（分别为P = 0.002、P < 0.0001和P = 0.03）。多变量分析显示，与BMD相关的最显著因素是年龄和BMI（P < 0.0001）。病程也存在微弱但具有统计学意义的相关性（P = 0.04）。
希腊IBD患者中骨质疏松症和骨质减少症的患病率较高。低BMI、年龄和病程是希腊IBD患者骨质疏松症最重要的独立危险因素。
