Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, MN, USA.
Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, MN, USA.
J Clin Densitom. 2020 Apr-Jun;23(2):182-189. doi: 10.1016/j.jocd.2019.07.009. Epub 2019 Jul 13.
Inflammatory bowel disease (IBD) is a chronic inflammatory medical condition with relapses and remission. Metabolic bone disease, including osteoporosis, is associated with IBD and imparts a significant morbidity if pathologic fractures were to occur. There has been a significant amount of research that evaluated the pathophysiology and associations between IBD and osteoporosis. Although corticosteroids contribute to the risk of low bone mineral density, osteoporosis and fractures, older age, female gender, smoking, and family history of fracture have been shown to contribute. Additionally, intestinal inflammation affects bone resorption and formation through proinflammatory cytokines such as tumor necrosis factor-a, interleukin-1, and interleukin-6 further accelerating bone loss. Little information is available on standardizing screening or treatment. It is important to recognize the risk factors that are associated with IBD and osteoporosis to identify the patient population at risk and initiate treatment/prevention strategies early. Treatment can include calcium, vitamin D, or bisphosphonates. Some studies showed benefit of treating the underlying IBD to improve bone mineral density.
炎症性肠病（IBD）是一种慢性炎症性疾病，会反复发作和缓解。代谢性骨病，包括骨质疏松症，与 IBD 相关，并会带来重大的发病率，如果发生病理性骨折的话。已经有大量的研究评估了 IBD 和骨质疏松症之间的病理生理学和关联。虽然皮质类固醇会增加低骨密度、骨质疏松症和骨折的风险，但年龄较大、女性、吸烟和骨折家族史也已被证明与之相关。此外，肠道炎症通过肿瘤坏死因子-α、白细胞介素-1 和白细胞介素-6 等促炎细胞因子影响骨吸收和形成，进一步加速骨质流失。关于标准化筛查或治疗的信息很少。重要的是要认识到与 IBD 和骨质疏松症相关的风险因素，以确定处于风险中的患者人群，并尽早开始治疗/预防策略。治疗可以包括钙、维生素 D 或双膦酸盐。一些研究表明，治疗潜在的 IBD 可以改善骨密度。
