Sahli Hélaa, , , Meddeb Nihela, Landolsi Fatena, Fekih Moniab, Boubaker Jalelb, Filali Azzab and Sellami Slaheddinea
aRheumatology Department, la Rabta, Tunis, Tunisia bGastroenterology Department, la Rabta, Tunis, Tunisia
Osteoporosis and osteopenia have been reported frequently in patients with inflammatory bowel disease, most notably Crohns disease.
Objectives. To determine the prevalence and risk factors of osteoporosis in patients with Crohns disease.
Methods. Prospective study of 56 patients with Crohns disease, 34 men and 22 women with a mean age of 32 ± 10.4 years (1854 years) and no history of disorders known to influence bone metabolism. Dual-energy X-ray absorptiometry measurements of bone mineral density (BMD) were obtained at the femoral neck and lumbar spine. A multivariate model including those factors significantly associated with low BMD in the univariate analysis was used to identify independent risk factors.
Results. Osteoporosis was found in 35.7% and osteopenia in 23.2% of patients. Low BMD was significantly associated with low body mass index (BMI), colonic involvement, and glucocorticoid therapy. Low BMI was an independent risk factor for low BMD. Malnutrition with BMI ≤18 kg/m2 was noted in 21 patients, of whom 76.2% had low BMD values, as compared to 48.6% of the patients whose BMI was >18 kg/m2 (P = 0.03, odds ratio = 3.4).
Conclusion. Among risk factors for bone loss in patients with Crohns disease, malnutrition plays a prominent role that deserves attention when planning treatment programs.
Joint Bone Spine Volume 72, Issue 5 , October 2005, Pages 403-407.