title: Prevalence and predictors of low bone mineral density in males with ulcerative colitis.
abstract: BACKGROUND
  Low bone mineral density (BMD) is common in patients with inflammatory bowel diseases.
  
  
  OBJECTIVE
  The objective of the study was to assess the prevalence and the predictors of low BMD (osteoporosis or osteopenia) and fragility fractures among men with ulcerative colitis.
  
  
  METHODS
  This was a retrospective database analysis.
  
  
  METHODS
  The study was conducted at a nationwide Veterans Affairs health care system.
  
  
  METHODS
  Male ulcerative colitis patients who were followed up in the Veterans Affairs system between 2001 and 2011 were identified using the International Classification of Diseases, ninth revision (ICD-9).
  
  
  METHODS
  We identified patients with low BMD and fragility fractures using ICD-9 codes. Steroid exposure was assessed using pharmacy data. A multivariate analysis was used to identify the independent effect of systemic steroids on the risk of low BMD and fragility fractures.
  
  
  RESULTS
  We identified 34 665 patients. Among them, 31% used steroids. The prevalence of low BMD was 15.8% and 7.1% among those who used and did not use steroids, respectively (P < .001). Prevalence of fragility fractures was 7.9%, 4.4%, and 1.1% for those with osteoporosis and osteopenia and those without low BMD, respectively (P < .001). Steroid exposure showed a dose-response pattern, patients who had cumulative prednisone exposure of greater than 11 136 mg (10th decile) were more likely to develop low BMD (odds ratio 8.9, P < .001) and fragility fractures (odds ratio 1.8, P < .001) as compared with non-steroid users after controlling for other possible predictors.
  
  
  CONCLUSIONS
  In this nationwide cohort, the prevalence of low BMD was higher than what was reported for the general male population. There was a strong correlation between the cumulative steroid use and the risk of low BMD. Both steroids and low BMD were independent risk factors for fragility fractures.
authors.affiliation: Southeast Louisiana Veterans Health Care System, Section of Gastroenterology and Hepatology, Tulane University Health Sciences Center, New Orleans, Louisiana 70112, USA. nabeel.khan@va.gov
authors.forename: Nabeel
authors.initials: N
authors.lastname: Khan
authors.forename: Ali M
authors.initials: AM
authors.lastname: Abbas
authors.forename: Rawaa M
authors.initials: RM
authors.lastname: Almukhtar
authors.forename: Amna
authors.initials: A
authors.lastname: Khan
mesh_terms: D015519:Bone Density; D003093:Colitis, Ulcerative / Q000150:complications* / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000453:epidemiology*; D058866:Osteoporotic Fractures / Q000453:epidemiology; D015995:Prevalence; D012189:Retrospective Studies