Low bone mineral density in Greek patients with inflammatory bowel disease: prevalence and risk factors.
BACKGROUND
A high prevalence of osteopenia and osteoporosis is observed in patients with inflammatory bowel disease (IBD). Various risk factors of bone loss have been suggested in IBD. The aim of the present study was to investigate the prevalence of low bone mineral density (BMD) and to identify related risk factors in Greek patients with IBD.


METHODS
One hundred and eighteen consecutive IBD patients were included. All patients underwent bone densitometry by dual energy X-ray absorptiometry at the femoral neck and lumbar spine levels. Serum levels of 25 hydroxyvitamin D (25 OH D), 1.25 dihydroxyvitamin D (1.25 OH 2D), osteocalcin, calcitonin and homocysteine were measured in all participants.


RESULTS
Forty (33.9%) patients were normal, 55 (46.6%) were osteopenic, and 23 (19.5%) were osteoporotic. No significant differences between IBD patients with osteopenia or osteoporosis and those with normal BMD concerning the use of steroids and the examined biochemical markers were found. Statistically significant differences among the three groups were found for body mass index (BMI), age and disease duration (P=0.002, P<0.0001 and P=0.03 respectively). Multivariate analysis revealed that the most significant factors associated with BMD were age and BMI (P<0.0001). A weak but statistically significant correlation was also found for disease duration (P=0.04).


CONCLUSIONS
There is a high prevalence of osteopenia and osteoporosis in Greek patients with IBD. Low BMI, age and disease duration are the most important independent risk factors for osteoporosis in Greek IBD patients.
Departments of Gastroenterology (Ioannis E. Koutroubakis, Christos Zavos, Elias A. Kouroumalis).
Ioannis E
IE
Koutroubakis
Departments of Gastroenterology (Ioannis E. Koutroubakis, Christos Zavos, Elias A. Kouroumalis).
Christos
C
Zavos
Medical Physics (John Damilakis).
John
J
Damilakis
Nuclear Medicine (Georgios Z. Papadakis, Nikolaos Karkavitsas).
Georgios Z
GZ
Papadakis
Radiology University Hospital of Heraklion (John Neratzoulakis), Crete, Greece.
John
J
Neratzoulakis
Nuclear Medicine (Georgios Z. Papadakis, Nikolaos Karkavitsas).
Nikolaos
N
Karkavitsas
Departments of Gastroenterology (Ioannis E. Koutroubakis, Christos Zavos, Elias A. Kouroumalis).
Elias A
EA
Kouroumalis
Crohn’s disease; bone mineral density; osteocalcin; ulcerative colitis; vitamin D