Zhao Yuan, Li Xiao Xuan, Li Fan, Yao Ling Ya, Liu Jing, Cao Qian
Department of Gastroenterology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China.
J Dig Dis. 2023 Jun-Jul;24(6-7):390-398. doi: 10.1111/1751-2980.13213. Epub 2023 Aug 26.
Bone loss is a common morbidity in patients with inflammatory bowel disease (IBD). Bone mineral density (BMD) measurement is recommended for IBD patients at a high risk of osteoporosis. However, there is a lack of evidence in the need of BMD measurement in patients who are young at the first disease onset. In this study we aimed to investigate the prevalence of low BMD in patients with newly diagnosed Crohn's disease (CD) at 20-50 years of age and the potential risk factors.
A single-center, retrospective cross-sectional study was conducted. Medical records of the patients were reviewed and their demographics, clinical characteristics and laboratory test results were collected. Dual energy X-ray absorptiometry (DEXA) scan was performed for BMD measurements; low BMD was defined as Z-score or T-score <-1.0 standard deviation (SD). Univariate and multivariate logistic regression analyses were used to determine the risk factors for low BMD.
A total of 221 patients with CD were included; osteopenia and osteoporosis were identified in 23.1% and 8.6%, and 39.4% and 7.2% of the patients using Z-score and T-score, respectively. Female gender and a higher BMI at diagnosis were protective factors for low BMD.
Low BMD is common in patients with newly diagnosed CD aged 20-50 years. Female gender and a higher BMI at diagnosis might protect CD patients from bone loss. Therefore, BMD measurement and early intervention with calcium and vitamin D are recommended for these patients.
骨质流失是炎症性肠病（IBD）患者的常见病症。对于骨质疏松风险较高的IBD患者，建议进行骨密度（BMD）测量。然而，对于初发病时年龄较轻的患者是否需要进行BMD测量，目前缺乏相关证据。在本研究中，我们旨在调查20至50岁新诊断的克罗恩病（CD）患者中低骨密度的患病率及其潜在风险因素。
进行了一项单中心回顾性横断面研究。回顾了患者的病历，并收集了他们的人口统计学、临床特征和实验室检查结果。采用双能X线吸收法（DEXA）扫描进行BMD测量；低骨密度定义为Z值或T值＜-1.0标准差（SD）。采用单因素和多因素逻辑回归分析来确定低骨密度的风险因素。
共纳入221例CD患者；分别采用Z值和T值时，骨质减少和骨质疏松的检出率分别为23.1%和8.6%，以及39.4%和7.2%。女性性别和诊断时较高的体重指数是低骨密度的保护因素。
低骨密度在20至50岁新诊断的CD患者中很常见。女性性别和诊断时较高的体重指数可能会保护CD患者不发生骨质流失。因此，建议对这些患者进行BMD测量，并早期补充钙和维生素D进行干预。
