Bone mineral density in Iranian patients with inflammatory bowel disease.
Patients with inflammatory bowel disease (IBD) are at increased risk of developing osteopenia and osteoporosis. The aim of the study was to investigate the prevalence of decreased bone density and related risk factors in Iranian IBD patients. A total of 126 ulcerative colitis (UC) and 39 Crohn's disease (CD) patients were enrolled. Dual-energy x-ray absorptiometry technique was used to measure bone density, and blood samples were obtained to measure biochemical markers. To find predictive variables for bone mineral density (BMD), stepwise regression analysis was carried out. A total of 53 IBD patients (32.1%) had diminished bone mineral density at either lumbar spine (L1-L4) or femoral neck. Of these, 9 (5.4%) had osteoporosis; however, 44 (26.7%) were osteopenic. Femoral neck bone density was significantly decreased among CD patients (p<0.04). There was no significant difference in BMD between men and women. We have found significant differences in BMD T scores at lumbar L1-L4, L2-L4, and femoral neck in corticosteroid ever-users (p<0.002, p<0.001, p<0.003, respectively). There was no significant difference in biochemical markers between UC and CD patients, except that more CD patients were hypocalcemic (p<0.001). Stepwise regression analysis has revealed lumbar spine T score was predicted by age (p<0.0001), corticosteroid use (p<0.002), and body mass index (BMI) (p<0.005); however, femoral neck was predicted by age (p<0.0001), BMI (p<0.0001), smoking (p<0.009), and corticosteroid use (p<0.028). Low bone density in Iranian UC and CD patients is in accordance with Western societies. Treatment with corticosteroid has increased this possibility in both groups. Corticosteroid use, age, smoking, and BMI are predictive factors for low bone density.
Zali
Mohammadreza
M
Department of Inflammatory Bowel Disease, Research Center for Gastroenterology and Liver Diseases, Shaheed Beheshti University of Medical Sciences, Tehran, Iran.
Bahari
Ali
A
Firouzi
Farzad
F
Daryani
Nasser Ebrahimi
NE
Aghazadeh
Rahim
R
Emam
Mohammad Mehdi
MM
Rezaie
Ali
A
Shalmani
Hamid Mohaghegh
HM
Naderi
Nosratollah
N
Maleki
Baharak
B
Sayyah
Alireza
A
Bashashati
Mohammad
M
Jazayeri
Haniehsadat
H
Zand
Shima
S
D015502:Absorptiometry, Photon; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D015519:Bone Density / Q000187:drug effects; D001851:Bone Diseases, Metabolic / Q000453:epidemiology / Q000503:physiopathology; D003093:Colitis, Ulcerative / Q000453:epidemiology / Q000503:physiopathology*; D003424:Crohn Disease / Q000453:epidemiology / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D005272:Femur Neck / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008159:Lumbar Vertebrae / Q000187:drug effects / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology / Q000503:physiopathology; D011237:Predictive Value of Tests; D011884:Radius / Q000187:drug effects / Q000503:physiopathology; D012044:Regression Analysis; D012307:Risk Factors
D000305:Adrenal Cortex Hormones; D015415:Biomarkers