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Osteoporosis risk heightened among patients with Crohn’s disease
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Inflammatory bowel disease, particularly Crohn’s disease, increased the risk for developing osteoporosis, according to a recent study.
Researchers evaluated results from bone mineral density (BMD) tests for 1,230 patients with IBD, along with 44,844 controls without IBD. Testing was performed via dual-energy X-ray absorptiometry on the first four lumbar vertebrae, total hip, femoral neck and trochanter. The cohort, drawn from the University of Manitoba IBD Epidemiologic Database, included 719 cases of Crohn’s disease (CD) and 511 of ulcerative colitis (UC).
Logistic regression analysis adjusting for age, sex, BMI and use of glucocorticoids, hormone replacement and antiresorptive osteoprotective medications indicated a small but significant increase to osteoporosis risk at one or more measured sites associated with IBD (OR=1.2; 95% CI, 1.02-1.40), but no significant associations were observed at individual measured sites.
After stratification according to IBD subtype, investigators noted significant associations between CD and osteoporosis in general (OR=1.47; 95% CI, 1.20-1.78) and at the trochanter (OR=1.62; 95% CI, 1.27-2.06) and lumbar spine specifically (OR=1.34; 95% CI, 1.06-1.70). UC did not increase osteoporosis risk at any sites and was associated with reduced risk at the trochanter (OR=0.63; 95% CI, 0.43-0.92).
Advanced age and decreases in BMI were significantly associated with osteoporosis risk and lower T-scores, overall and at each measured site. Patients with CD were more likely to have osteoporosis at the trochanter, total hip and femoral neck compared with UC patients, and faced increased risk for lower T-scores.
“Although overall IBD is not a major independent risk for developing osteoporosis, those patients specifically with CD appeared to be at an independently increased risk for decreased BMD and osteoporosis,” the researchers wrote. “The risk factors for low BMD and osteoporosis within the population of IBD subjects are similar to well-established risk factors in the population at large and support current guidelines recommending selective screening for metabolic bone disease in persons with IBD. In addition, patients with CD may warrant more aggressive screening for low BMD, even in the absence of other risk factors for osteoporosis.”
Disclosure: See the study for a full list of relevant disclosures.
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