Metabolic bone disease in inflammatory bowel disease.
Osteoporosis is associated with a high morbidity rate and is a risk factor for fractures. Patients with inflammatory bowel disease are at increased risk of developing osteopenia and osteoporosis. Corticosteroid use, malnutrition, and proinflammatory cytokines are unique risk factors for bone loss in ulcerative colitis and Crohn disease. Bone mineral density is assessed by dual-energy X-ray absorptiometry and reported as a T score or number of standard deviations away from the mean. A T score < 1 SD below the mean is normal, 1 to 2.5 SD below the mean is consistent with osteopenia, and greater than 2.5 SD below the mean is defined as osteoporosis. Treatment includes a combination of basic preventative measures, for example, weight-bearing exercise, calcium, vitamin D, and pharmacologic agents, (e.g., bisphosphonates).
Harpavat
Manisha
M
Inflammatory Bowel Disease Program, Children's Hospital of Pittsburgh, Division of Pediatric Gastroenterology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15212, USA.
Keljo
David J
DJ
Regueiro
Miguel D
MD
D015519:Bone Density; D004164:Diphosphonates / Q000627:therapeutic use; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D018836:Inflammation Mediators / Q000502:physiology; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism; D044342:Malnutrition / Q000503:physiopathology; D010024:Osteoporosis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D012307:Risk Factors
D004164:Diphosphonates; D005938:Glucocorticoids; D018836:Inflammation Mediators