title: Health care for osteoporosis in inflammatory bowel disease: unmet needs in care of male patients?
abstract: OBJECTIVE
  Osteoporosis is a frequent complication of inflammatory bowel disease (IBD). It may be related to IBD itself or to its therapy. In this study, the quality of care regarding diagnosis and treatment of osteoporosis was examined.
  
  
  METHODS
  In this retrospective, monocentric study 293 consecutive patients with IBD (98 ulcerative colitis, 195 Crohn's disease) were included. Information on age, gender, weight, nicotine abuse, course, disease pattern and medication was assessed, results of dual X-ray absorptiometry (DEXA-scan) were evaluated.
  
  
  RESULTS
  DEXA-scan was performed in 174 patients (59 male, 115 female). Bone mineral density (BMD) was impaired in 38.5% of these patients. Male patients were diagnosed more often with osteopenia or osteoporosis than females (55.9% vs. 29.6%, p=0.03) and had a risk of bone disease comparable to postmenopausal women. Additionally, duration of corticosteroid treatment and IBD were identified as risk factors for osteoporosis. Follow up DEXA-scan demonstrated an overall deterioration of BMD in patients with normal baseline results.
  
  
  CONCLUSIONS
  While in general, women are considered at higher risk for osteoporosis, male patients had a higher risk of impaired BMD, especially when under treatment with corticosteroids. The high incidence of reduced BMD supports the recommendation to screen patients with IBD at an early stage of disease, although a possible bias has to be considered for patients at a tertial referral centre for IBD. Patients with normal baseline DEXA-scan were still at risk to develop bone disease and it seems advisable to monitor patients with IBD for reduced BMD continually.
authors: Department of Internal Medicine I, Martin Luther University of Halle-Wittenberg, Germany. Electronic address: jens.walldorf@medizin.uni-halle.de.
authors: Jens
authors: J
authors: Walldorf
authors: Annette
authors: A
authors: Krummenerl
authors: Kristin
authors: K
authors: Engler
authors: Juliane
authors: J
authors: Busch
authors: Matthias M
authors: MM
authors: Dollinger
authors: Thomas
authors: T
authors: Seufferlein
authors: Jörg G
authors: JG
authors: Albert
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000367:Age Factors; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D015897:Comorbidity; D003424:Crohn Disease / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D003695:Delivery of Health Care / Q000592:standards* / Q000639:trends; D005260:Female; D005858:Germany; D006801:Humans; D015994:Incidence; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010024:Osteoporosis / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012737:Sex Factors
keywords: Colitis ulcerosa; Crohn's disease; Inflammatory bowel disease; Osteoporosis