© 2002 by Gut
CLINICAL @LERT
Osteoporosis in patients with inflammatory bowel disease
MRC Epidemiology Unit, Southampton General Hospital, Southampton, UK
Correspondence to:
Correspondence to:
Dr N Arden, MRC Epidemiology Unit, Southampton General Hospital, Tremona Road, Southampton SOI6 6YD, UK;
nka@mrc.soton.ac.uk
Increased incidence of "fragility" fractures in patients with inflammatory bowel disease
Keywords: osteoporosis; inflammatory bowel disease; fractures
There is consistent evidence that patients with inflammatory bowel disease (IBD) have an increased risk of osteoporosis, defined by reduced bone mineral density (BMD).1 The important clinical end point of osteoporosis however, is fractures; these are associated with significant morbidity and mortality and healthcare costs. The retrospective cohort study of Bernstein et al shows a 40% increase in the risk of fracture among patients with IBD compared with age and sex matched controls.2 The increased risk was similar in patients with Crohn's disease (CD) and ulcerative colitis (UC). These results differ from a large Danish case control study which reported a 2.5-fold increase in the risk of fracture among women with CD but failed to demonstrate a statistically significant increased risk among men with CD or patients with UC.3 The literature on BMD in IBD is also discordant when comparing the risk of osteoporosis in patients with CD with those
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