title: Low bone mineral density linked to colorectal adenomas: a cross-sectional study of a racially diverse population.
abstract: BACKGROUND
  Epidemiologic studies suggest that lower bone mineral density (BMD) is associated with an increased risk for colorectal adenoma/cancer, especially in postmenopausal women. The aim of this study is to investigate the association between osteopenia and/or osteoporosis and colorectal adenomas in patients from a New York community hospital.
  
  
  METHODS
  We performed a cross-sectional observational study on 200 patients who underwent screening colonoscopies and bone density scan (dual-energy X-ray absorptiometry) at Nassau University Medical Center from November 2009 to March 2011. Among these, 83 patients were identified as osteoporosis (T score of -2.5 or below) and 67 were osteopenia (T score between -1.0 and -2.5). Logistic regression model was performed to assess the association between osteopenia and/or osteoporosis and colorectal adenomas.
  
  
  RESULTS
  Among the patients with osteopenia and osteoporosis, the mean ages were 59.1 years [standard deviation (SD) =8.9] and 61.5 (SD =8.9), respectively. There were 94.0%, 85.1% and 74.7% women, respectively, in normal BMD, osteopenia and osteoporosis groups. The prevalence of colorectal adenomas was 17.9% and 25.3% in the osteopenia and osteoporosis groups, respectively, and 18.0% in the normal BMD group. After adjustment for potential confounders including age, sex, race, body mass index (BMI), tobacco use, alcohol use, history of diabetes, hypertension, or dyslipidemia, osteoporosis was found to be associated with presence of colorectal adenomas more than 2, compared to the normal BMD group. No significant associations were found for the prevalence, size, and location of adenomas.
  
  
  CONCLUSIONS
  Our study suggests that osteoporosis is significantly associated with the presence of multiple colorectal adenomas. Prospective studies with a larger sample size are warranted in the future.
authors.affiliation: 1 Division of Occupational and Environmental Health Sciences, University of Washington School of Medicine and University of Washington School of Public Health, Seattle, WA, USA ; 2 Division of Digestive Diseases and Nutrition, 3 Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: Shilpa
authors.initials: S
authors.lastname: Gowda
authors.affiliation: 1 Division of Occupational and Environmental Health Sciences, University of Washington School of Medicine and University of Washington School of Public Health, Seattle, WA, USA ; 2 Division of Digestive Diseases and Nutrition, 3 Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: Seth
authors.initials: S
authors.lastname: Lipka
authors.affiliation: 1 Division of Occupational and Environmental Health Sciences, University of Washington School of Medicine and University of Washington School of Public Health, Seattle, WA, USA ; 2 Division of Digestive Diseases and Nutrition, 3 Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: Ashley H
authors.initials: AH
authors.lastname: Davis-Yadley
authors.affiliation: 1 Division of Occupational and Environmental Health Sciences, University of Washington School of Medicine and University of Washington School of Public Health, Seattle, WA, USA ; 2 Division of Digestive Diseases and Nutrition, 3 Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: Huafeng
authors.initials: H
authors.lastname: Shen
authors.affiliation: 1 Division of Occupational and Environmental Health Sciences, University of Washington School of Medicine and University of Washington School of Public Health, Seattle, WA, USA ; 2 Division of Digestive Diseases and Nutrition, 3 Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Silpe
authors.affiliation: 1 Division of Occupational and Environmental Health Sciences, University of Washington School of Medicine and University of Washington School of Public Health, Seattle, WA, USA ; 2 Division of Digestive Diseases and Nutrition, 3 Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: Andy
authors.initials: A
authors.lastname: White
authors.affiliation: 1 Division of Occupational and Environmental Health Sciences, University of Washington School of Medicine and University of Washington School of Public Health, Seattle, WA, USA ; 2 Division of Digestive Diseases and Nutrition, 3 Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: Sam
authors.initials: S
authors.lastname: Satler
authors.affiliation: 1 Division of Occupational and Environmental Health Sciences, University of Washington School of Medicine and University of Washington School of Public Health, Seattle, WA, USA ; 2 Division of Digestive Diseases and Nutrition, 3 Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: Dustin
authors.initials: D
authors.lastname: Luebbers
authors.affiliation: 1 Division of Occupational and Environmental Health Sciences, University of Washington School of Medicine and University of Washington School of Public Health, Seattle, WA, USA ; 2 Division of Digestive Diseases and Nutrition, 3 Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: James
authors.initials: J
authors.lastname: Statler
authors.affiliation: 1 Division of Occupational and Environmental Health Sciences, University of Washington School of Medicine and University of Washington School of Public Health, Seattle, WA, USA ; 2 Division of Digestive Diseases and Nutrition, 3 Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Zheng
authors.affiliation: 1 Division of Occupational and Environmental Health Sciences, University of Washington School of Medicine and University of Washington School of Public Health, Seattle, WA, USA ; 2 Division of Digestive Diseases and Nutrition, 3 Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Elder
authors.affiliation: 1 Division of Occupational and Environmental Health Sciences, University of Washington School of Medicine and University of Washington School of Public Health, Seattle, WA, USA ; 2 Division of Digestive Diseases and Nutrition, 3 Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: Albin
authors.initials: A
authors.lastname: Abraham
authors.affiliation: 1 Division of Occupational and Environmental Health Sciences, University of Washington School of Medicine and University of Washington School of Public Health, Seattle, WA, USA ; 2 Division of Digestive Diseases and Nutrition, 3 Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: Prakash
authors.initials: P
authors.lastname: Viswanathan
authors.affiliation: 1 Division of Occupational and Environmental Health Sciences, University of Washington School of Medicine and University of Washington School of Public Health, Seattle, WA, USA ; 2 Division of Digestive Diseases and Nutrition, 3 Department of Medicine, University of South Florida Morsani College of Medicine, Tampa, FL, USA ; 4 Department of Medicine, 5 Division of Gastroenterology and Hepatology, Department of Medicine, Nassau University Medical Center, East Meadow, NY, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Mustacchia
keywords: Bone mineral density (BMD); colonoscopy; colorectal adenoma; osteoporosis
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