Introduction Many factors can contribute to bone loss in Inflammatory bowel disease (IBD) patients treated with oral steroids.
Methods To assess the prevalence and evaluate the impact of various factors on bone density in IBD patients treated with oral steroids. We conducted a retrospective study on 50 patients with ulcerative colitis (UC) and 40 patients with Crohn's disease. BMD of lumbar spine and femoral neck were measured by axial dual-energy x-ray absorpiometry scan (DEXA) in 57 patients, and that of forearm by peripheral DEXA scan in 33 patients.
Results 60% of all patients (n=55) had low BMD (8.8% were osteoporotic, 51% were osteopenic). The osteoporotics were predominantly (75%) patients with CD and were smokers. On the other hand, 63% of osteopenics had UC and 28% were smokers. Although most of males (80.7%) had low BMD (73.3% were aged <50 years), only one third of females below the age of 45 years had low BMD. Only five patients had BMI <19, the majority of these patients (80%) had low BMD. All of the osteoporotic CD patients had terminal ileum (TI) involvement, and nearly 60% of patients who underwent surgery for CD had low bone mineral density. Patients who had IBD for 10 years showed low BMD in 62.5%, while 54% of those with disease duration more than 10 years had low BMD. 40% of patients who were on steroid sparing agents had normal BMD. All of the osteoporotic female patients were aged >45 years and were not on bone protection.
Conclusion The high prevalence of bone loss in IBD patients treated with oral steroids is multifactorial. Disease type (CD), site of the disease (TI), disease severity (requiring oral steroids and surgical intervention) and low BMI seems to be the major variables and early bone protection is recommended especially in young men.
Competing interests None declared.
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