title: Clinical Course of Bone Metabolism Disorders in Patients with Inflammatory Bowel Disease: A 5-Year Prospective Study.
abstract: The clinical course of bone mineral density (BMD) disorders and the efficacy of treatment of osteopenia and osteoporosis have been poorly studied in patients with inflammatory bowel disease (IBD). The objective was to study the course of BMD disorders in patients with IBD, analyze the factors influencing their development, and assess the effect of treatment with calcium, vitamin D, and bisphosphonates.
  
  
  
  Consecutive patients with IBD were included and followed up for 5 years. After a baseline densitometry, calcium (1000 mg/d) and vitamin D (800 IU/d) were administered to patients with osteopenia; bisphosphonates to patients with osteoporosis; and patients with normal BMD were only followed-up. After completing the follow-up period, a second densitometry was performed.
  
  
  
  One hundred patients were initially included, 60% having a low BMD (44% osteopenia and 16% osteoporosis). Fifty-eight patients completed the follow-up period. At baseline, osteopenia was more frequently found in Crohn's disease than in ulcerative colitis (63% versus 21%, P < 0.05). In patients with normal BMD at baseline, age, smoking habit, and the presence of flares during follow-up were associated with the development of osteopenia. Treatment with calcium and vitamin D improved the hip T-score in patients with osteopenia (-1.03 versus -0.58, P < 0.001) and bisphosphonates provided the same improvement (-1.482 versus -1.072, P < 0.05) in patients with osteoporosis.
  
  
  
  Age, smoking habit, and IBD activity negatively influence the clinical course of BMD. Treatment with calcium and vitamin D improves hip T-score in patients with osteopenia whereas bisphosphonates improve hip T-score in patients with osteoporosis.
authors.affiliation: Gastroenterology Unit, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa (IIS-IP) and Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Casals-Seoane
authors.forename: María
authors.initials: M
authors.lastname: Chaparro
authors.forename: José
authors.initials: J
authors.lastname: Maté
authors.forename: Javier P
authors.initials: JP
authors.lastname: Gisbert
mesh_terms: D000328:Adult; D000367:Age Factors; D015519:Bone Density; D050071:Bone Density Conservation Agents / Q000627:therapeutic use; D001851:Bone Diseases, Metabolic / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D002118:Calcium / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000150:complications*; D003424:Crohn Disease / Q000150:complications*; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects; D000067251:Symptom Flare Up; D016896:Treatment Outcome; D014807:Vitamin D / Q000627:therapeutic use
chemical_list: D050071:Bone Density Conservation Agents; D004164:Diphosphonates; D014807:Vitamin D; D002118:Calcium