Metabolic bone disease in patients diagnosed with inflammatory bowel disease from Spain

• Published in: Therapeutic advances in gastroenterology Vol. 12; p. 1756284819862152
• Main Authors: Miranda-Bautista, José, Verdejo, Cristina, Díaz-Redondo, Alicia, Bretón, Irene, Bellón, José M., Pérez-Valderas, María Dolores, Caballero-Marcos, Aránzazu, de Dios-Lascuevas, Marta, González-Río, Elena, García-Sánchez, Cristina, Marín-Jiménez, Ignacio, Bañares, Rafael, Menchén, Luis
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.07.2019; Sage Publications Ltd; SAGE Publishing
• Subjects: Bone diseases; Gastroenterology; Health risk assessment; Inflammatory bowel disease; Longitudinal studies; Metabolism; Original Research; Osteoporosis; osteopenia; dual energy X-ray absorptiometry; steroids; ulcerative colitis; osteoporosis; inflammatory bowel disease; Crohn’s disease
• ISSN: 1756-2848; 1756-283X; 1756-2848
• DOI: 10.1177/1756284819862152

Background: The objective of this study was to analyse the prevalence of metabolic bone disease (MBD) in a cohort of Southern European patients with inflammatory bowel disease (IBD) and to identify associated risk factors in this population. Methods: We conducted a retrospective, both cross-sectional and longitudinal study of MBD, assessed by dual energy X-ray absorptiometry (DXA), among patients diagnosed with IBD and previously recognized risk factors for this complication from two referral Spanish institutions. Results: A total of 612 patients (58.6% diagnosed with Crohn’s disease) were included. Mean (SD) age was 44.9 (14.7) years; 71.7% of patients received at least one tapered dosage of corticosteroids before first DXA. MBD and osteoporosis were diagnosed in 66.4% and 21.4% of patients, respectively. At baseline, male gender, menopause and ulcerative colitis were found as independent risks factors for osteoporosis, whereas age, more than three IBD-related hospitalizations and previous steroid treatment were found as independent risks factors for MBD. A total of 261 patients had at least a second DXA and were included in the longitudinal study; median follow up was 56.4 months. Logistic regression model identified menopause, ulcerative colitis and baseline lumbar DXA T-score value, but not steroid treatment, as risk factors for worsening ⩾1 SD in follow-up DXA T-score. According to guidelines, all patients under treatment with corticosteroids received calcium and vitamin D supplements. Conclusion: MBD is a frequent complication in south-European IBD patients. Routine evaluation of bone density when risk factors are present, as well as calcium plus D vitamin prophylaxis in patients under corticosteroid treatment should be recommended.