Osteopenia and osteoporosis in Crohn's disease: prevalence in a Dutch population-based cohort.
Reduced bone mineral density (BMD) has been reported in 3-77% of patients with inflammatory bowel disease (IBD). The majority of these studies are cross-sectional and from tertiary referral centres. The aim of our study was to estimate the prevalence of metabolic bone disease and of symptomatic fractures in a population of patients with Crohn's disease (CD) living in a well-defined geographic area. Patients with CD living in three adjacent municipalities within the IBD South-Limburg study area were investigated. BMD was measured by dual X-ray absorptiometry (DXA) of the femoral neck, lumbar spine and total body. The population comprised of 181 CD patients, 23 of whom were excluded. One-hundred-and-nineteen (75%) of the 158 eligible patients (37 males, 82 females with a mean age of 42 years (17-78)) were investigated. Osteopenia of lumbar spine and/or femoral neck was found in 45% of patients. Osteoporosis was found in another 13% of patients. Mean BMD (T-score) of femoral neck was significantly lower than of lumbar spine (P < 0.001). Male CD patients and patients aged under 18 at diagnosis are more at risk of having a low bone mass at the lumbar spine (P < 0.001) and total body (P = 0.018). The prevalence of osteoporosis in postmenopausal CD patients (29%) was significantly higher than in premenopausal patients (3%) (odds ratio: 12). Twenty-nine of 119 (24%) patients had a history of symptomatic fractures. Osteopenia and osteoporosis are frequent in CD and should have the full attention of the treating physician.
Schoon
E J
EJ
Dept. of Gastroenterology-Hepatology, University Hospital Maastricht, P.O. Box 5800, NL- 6202 AZ,  Maastricht, The Netherlands.
van Nunen
A B
AB
Wouters
R S
RS
Stockbrügger
R W
RW
Russel
M G
MG
D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000368:Aged; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000453:epidemiology* / Q000209:etiology / Q000378:metabolism; D003424:Crohn Disease / Q000150:complications* / Q000453:epidemiology / Q000378:metabolism; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000378:metabolism; D005598:Fractures, Spontaneous / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010024:Osteoporosis / Q000453:epidemiology / Q000209:etiology / Q000378:metabolism; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution