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胃肠道疾病中的骨质疏松症和骨质疏松性骨折

Osteoporosis and Osteoporotic Fractures in Gastrointestinal Disease.

作者信息

Oh Hyun Jin, Ryu Kum Hei, Park Bum Joon, Yoon Byung-Ho

机构信息

Division of Gastroenterology, Department of Internal Medicine, Center for Cancer Prevention and Detection, National Cancer Center, Goyang, Korea.

Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.

出版信息

J Bone Metab. 2018 Nov;25(4):213-217. doi: 10.11005/jbm.2018.25.4.213. Epub 2018 Nov 30.

Abstract

Patients with gastrointestinal disease (GI) are at risk for osteopenia or osteoporosis, which can lead to fractures. Although these patients may be at risk from a young age, gastroenterologists often overlook this fact in practice. There are well-known GI diseases associated with osteopenia and osteoporosis, such as the post-gastrectomy state, inflammatory bowel disease (IBD), and celiac disease. As there is an increase in the prevalence of IBD patients, newly diagnosed celiac disease in adulthood, and gastric cancer survivors following gastrectomy, bone disease in these patients becomes an important issue. Here, we have discussed osteoporosis and fractures in GI disease, especially in the post-gastrectomy state, IBD, and celiac disease. Although the pathogenesis of bone loss in each disease has not been fully identified, we have confirmed that the prevalence of osteoporosis and fractures in each of these diseases is high. There are scarce studies comparing the prevalence of osteoporosis or osteoporotic fractures in GI disease patients with studies in postmenopausal women, and specific guidelines for their management in each disease have not been established. Intensive surveillance and management are needed to ensure that these patients attain peak bone mass for age and sex to prevent fractures.

摘要

患有胃肠道疾病(GI)的患者存在骨质减少或骨质疏松的风险,这可能导致骨折。尽管这些患者从年轻时起就可能面临风险,但胃肠病学家在实际工作中往往忽略这一事实。有一些众所周知的与骨质减少和骨质疏松相关的胃肠道疾病,如胃切除术后状态、炎症性肠病(IBD)和乳糜泻。随着IBD患者患病率的增加、成年期新诊断出的乳糜泻以及胃切除术后的胃癌幸存者,这些患者的骨病成为一个重要问题。在此,我们讨论了胃肠道疾病中的骨质疏松和骨折,特别是在胃切除术后状态、IBD和乳糜泻中。尽管每种疾病中骨质流失的发病机制尚未完全明确,但我们已证实这些疾病中骨质疏松和骨折的患病率都很高。将胃肠道疾病患者的骨质疏松或骨质疏松性骨折患病率与绝经后女性的研究进行比较的研究很少,并且尚未针对每种疾病制定具体的管理指南。需要进行强化监测和管理,以确保这些患者达到适合其年龄和性别的峰值骨量,从而预防骨折。

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