Department of Gastroenterology and Hepatology, Kasturba Hospital, Manipal Academy of Higher Education, Manipal, Udupi, 576 104, India.
Department of Orthopedics, Kasturba Hospital, Manipal Academy of Higher Education, Manipal, Udupi, 576 104, India.
Indian J Gastroenterol. 2020 Aug;39(4):346-353. doi: 10.1007/s12664-020-01048-5. Epub 2020 Sep 17.
Patients with inflammatory bowel disease (IBD) have numerous risk factors for low bone mineral density (BMD). We aimed to study the prevalence of low BMD in IBD and the factors associated with it.
BMD was measured by radial quantitative ultrasound, and clinical and biochemical characteristics were compared in prospectively enrolled patients and healthy age and gender-matched controls. Chi-square test, t test for independent samples, analysis of variance (ANOVA), Mann-Whitney U test and Kruskal-Wallis H tests were used as appropriate for univariate analysis to compare the characteristics between patients with and without abnormal BMD. Binary logistic regression analysis was done to determine the factors associated with low BMD in IBD patients.
One hundred and six patients (Crohn's disease [CD] = 35, ulcerative colitis [UC] = 71) and 55 controls were included. Low BMD was equally prevalent in CD, UC and controls (42.9%, 36.6%, 36.4% respectively, p = 0.791). Serum calcium and vitamin D were significantly lower in IBD patients compared to controls (p < 0.001 and p = 0.003, respectively) but not between patients with low and normal BMD. Older age (Odds ratio [OR] = 66.12 [9.299-470.243], p < 0.001), late onset of disease (OR = 4.795 [1.067-21.543], p = 0.041) and absence of steroid usage (OR = 0.272 [0.089-0.832], p = 0.022) were significantly associated with low BMD.
The prevalence of low BMD in patients with IBD was similar to controls and this was associated with increasing age, late onset of disease, and absence of steroid usage. Judicious use of steroids can help preserve bone health in IBD.
炎症性肠病（IBD）患者存在许多导致骨密度降低（BMD）的风险因素。我们旨在研究 IBD 患者中低 BMD 的患病率以及与低 BMD 相关的因素。
通过桡骨定量超声测量 BMD，并对前瞻性入组的患者和年龄、性别匹配的健康对照者的临床和生化特征进行比较。采用卡方检验、独立样本 t 检验、方差分析（ANOVA）、Mann-Whitney U 检验和 Kruskal-Wallis H 检验进行单因素分析，比较 BMD 正常和异常患者的特征。采用二元逻辑回归分析确定与 IBD 患者低 BMD 相关的因素。
共纳入 106 例患者（克罗恩病 [CD] 35 例，溃疡性结肠炎 [UC] 71 例）和 55 例对照者。CD、UC 和对照组的低 BMD 患病率相似（分别为 42.9%、36.6%和 36.4%，p=0.791）。与对照组相比，IBD 患者的血清钙和维生素 D 明显降低（p<0.001 和 p=0.003），但低 BMD 患者与正常 BMD 患者之间并无差异。年龄较大（比值比 [OR] 66.12[9.299-470.243]，p<0.001）、疾病发病较晚（OR 4.795[1.067-21.543]，p=0.041）和无激素使用史（OR 0.272[0.089-0.832]，p=0.022）与低 BMD 显著相关。
IBD 患者的低 BMD 患病率与对照组相似，且与年龄增长、疾病发病晚和无激素使用史有关。合理使用激素有助于维持 IBD 患者的骨骼健康。
