Osteoporosis and Crohn's disease.
Osteoporosis and osteopenia have been reported frequently in patients with inflammatory bowel disease, most notably Crohn's disease.


OBJECTIVE
To determine the prevalence and risk factors of osteoporosis in patients with Crohn's disease.


METHODS
Prospective study of 56 patients with Crohn's disease, 34 men and 22 women with a mean age of 32 +/- 10.4 years (18-54 years) and no history of disorders known to influence bone metabolism. Dual-energy X-ray absorptiometry measurements of bone mineral density (BMD) were obtained at the femoral neck and lumbar spine. A multivariate model including those factors significantly associated with low BMD in the univariate analysis was used to identify independent risk factors.


RESULTS
Osteoporosis was found in 35.7% and osteopenia in 23.2% of patients. Low BMD was significantly associated with low body mass index (BMI), colonic involvement, and glucocorticoid therapy. Low BMI was an independent risk factor for low BMD. Malnutrition with BMI < or =18 kg/m2 was noted in 21 patients, of whom 76.2% had low BMD values, as compared to 48.6% of the patients whose BMI was >18 kg/m2 (P = 0.03, odds ratio = 3.4).


CONCLUSIONS
Among risk factors for bone loss in patients with Crohn's disease, malnutrition plays a prominent role that deserves attention when planning treatment programs.
Héla
Sahli
S
Rheumatology Department, la Rabta, Tunis, Tunisia. sahlisrairihela@yahoo.fr
Nihel
Meddeb
M
Faten
Landolsi
L
Monia
Fekih
F
Jalel
Boubaker
B
Azza
Filali
F
Slaheddine
Sellami
S
D000293:Adolescent; D000328:Adult; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D003424:Crohn Disease / Q000150:complications*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000209:etiology*; D008875:Middle Aged; D010024:Osteoporosis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D014416:Tunisia