Bone loss associated with gastrointestinal disease: prevalence and pathogenesis.
Decreased bone mineral density is a frequent finding in gastrointestinal disease. Factors contributing to this are (1) malabsorption of vitamin D, calcium and possibly vitamin K and other nutrients; (2) treatment with glucocorticoids; (3) inflammatory cytokines in inflammatory bowel disease; and (4) hypogonadism induced by gastrointestinal disease. A low bone mineral density has been reported in (1) patients who have undergone gastrectomy (27-44% with Z-scores of < -1); (2) pernicious anaemia; (3) coeliac disease (8-22% with Z-scores of < -2); (4) Crohn's disease (mean 32-38% with Z-scores of < -1); and (5) ulcerative colitis (mean 23-25% with Z-scores of < -1). Reduced bone mineral density is thus prevalent in these individuals and is compounded by age related bone loss, leading to the development of severe bone disease in some patients.
Vestergaard
Peter
P
The Osteoporosis Clinic, Aarhus Amtssygehus, Tage Hansens Gade 2, DK-8000 Aarhus C, Denmark. p-vest@post4.tele.dk
D000752:Anemia, Pernicious / Q000150:complications / Q000378:metabolism; D015519:Bone Density / Q000502:physiology; D002446:Celiac Disease / Q000150:complications / Q000378:metabolism; D003109:Colonic Diseases, Functional / Q000150:complications / Q000378:metabolism; D016207:Cytokines / Q000096:biosynthesis; D005743:Gastrectomy / Q000009:adverse effects; D005767:Gastrointestinal Diseases / Q000150:complications* / Q000378:metabolism; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D007006:Hypogonadism / Q000209:etiology / Q000378:metabolism; D008286:Malabsorption Syndromes / Q000150:complications / Q000378:metabolism; D010024:Osteoporosis / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology
D016207:Cytokines; D005938:Glucocorticoids