Risk factors for decreased bone mineral density in inflammatory bowel disease

A cross-sectional study

Yasuyo Wada, Tadakazu Hisamatsu, Makoto Naganuma, Katsuyoshi Matsuoka, Susumu Okamoto, Nagamu Inoue, Tomoharu Yajima, Keisuke Koyama, Yasushi Iwao, Haruhiko Ogata, Toshifumi Hibi, Takayuki Abe, Takanori Kanai

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background & aim: Although inflammatory bowel disease (IBD) patients are at risk for metabolic bone disease, studies analyzing this correlation have identified various risk factors, including disease phenotype, age, sex and steroid therapy. Furthermore, few studies have assessed risk factors for bone loss in Japanese IBD patients. This study analyzed risk factors for metabolic bone disease in Japanese IBD patients. Methods: This cross-sectional study assessed 388 patients with IBD aged 20-50 years, including 232 with ulcerative colitis (UC) and 156 with Crohn's disease (CD). Bone mineral density of the femoral neck, total femur and lumbar spine was quantified by dual-energy X-ray absorptiometry. The blood concentrations of bone metabolism markers were measured. History of smoking and bone fracture, and nutritional intake were assessed using questionnaires. Results: Of the 388 patients with IBD, 78 (20.1%; UC, 17.2%; CD, 24.4%) had osteopenia and 17 (4.4%; UC, 3.4%; CD, 5.8%) had osteoporosis, as assessed by T-score. Bone mineral density of the lumbar vertebrae was lower in males than in females. Multivariate regression analysis showed that risk factors for bone loss in UC patients were male sex, low body mass index (BMI), high steroid dose and disease location. Risk factors for bone loss in CD patients were male sex and low BMI. Conclusion: Among Japanese patients with IBD, male sex and low BMI were associated with increased risk for metabolic bone disease. In addition, Steroid therapy shouldn't be indiscriminate in UC patients. These findings may help identify patients at particularly high risk of metabolic bone disease and may help implement appropriate therapies in a timely manner and improve long-term quality of life.

Original languageEnglish
JournalClinical Nutrition
DOIs
Publication statusAccepted/In press - 2014 Jun 4

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Inflammatory Bowel Diseases
Bone Density
Cross-Sectional Studies
Metabolic Bone Diseases
Ulcerative Colitis
Crohn Disease
Bone and Bones
Body Mass Index
Steroids
Lumbar Vertebrae
Femur Neck
Bone Fractures
Photon Absorptiometry
Femur
Osteoporosis
Spine
Therapeutics
Multivariate Analysis
Smoking
Regression Analysis

Keywords

  • Body mass index
  • Crohn's disease
  • Inflammatory bowel disease
  • Japanese
  • Osteoporosis
  • Ulcerative colitis

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Nutrition and Dietetics

Cite this

Risk factors for decreased bone mineral density in inflammatory bowel disease : A cross-sectional study. / Wada, Yasuyo; Hisamatsu, Tadakazu; Naganuma, Makoto; Matsuoka, Katsuyoshi; Okamoto, Susumu; Inoue, Nagamu; Yajima, Tomoharu; Koyama, Keisuke; Iwao, Yasushi; Ogata, Haruhiko; Hibi, Toshifumi; Abe, Takayuki; Kanai, Takanori.

In: Clinical Nutrition, 04.06.2014.

Research output: Contribution to journalArticle

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abstract = "Background & aim: Although inflammatory bowel disease (IBD) patients are at risk for metabolic bone disease, studies analyzing this correlation have identified various risk factors, including disease phenotype, age, sex and steroid therapy. Furthermore, few studies have assessed risk factors for bone loss in Japanese IBD patients. This study analyzed risk factors for metabolic bone disease in Japanese IBD patients. Methods: This cross-sectional study assessed 388 patients with IBD aged 20-50 years, including 232 with ulcerative colitis (UC) and 156 with Crohn's disease (CD). Bone mineral density of the femoral neck, total femur and lumbar spine was quantified by dual-energy X-ray absorptiometry. The blood concentrations of bone metabolism markers were measured. History of smoking and bone fracture, and nutritional intake were assessed using questionnaires. Results: Of the 388 patients with IBD, 78 (20.1{\%}; UC, 17.2{\%}; CD, 24.4{\%}) had osteopenia and 17 (4.4{\%}; UC, 3.4{\%}; CD, 5.8{\%}) had osteoporosis, as assessed by T-score. Bone mineral density of the lumbar vertebrae was lower in males than in females. Multivariate regression analysis showed that risk factors for bone loss in UC patients were male sex, low body mass index (BMI), high steroid dose and disease location. Risk factors for bone loss in CD patients were male sex and low BMI. Conclusion: Among Japanese patients with IBD, male sex and low BMI were associated with increased risk for metabolic bone disease. In addition, Steroid therapy shouldn't be indiscriminate in UC patients. These findings may help identify patients at particularly high risk of metabolic bone disease and may help implement appropriate therapies in a timely manner and improve long-term quality of life.",
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T2 - A cross-sectional study

AU - Wada, Yasuyo

AU - Hisamatsu, Tadakazu

AU - Naganuma, Makoto

AU - Matsuoka, Katsuyoshi

AU - Okamoto, Susumu

AU - Inoue, Nagamu

AU - Yajima, Tomoharu

AU - Koyama, Keisuke

AU - Iwao, Yasushi

AU - Ogata, Haruhiko

AU - Hibi, Toshifumi

AU - Abe, Takayuki

AU - Kanai, Takanori

PY - 2014/6/4

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N2 - Background & aim: Although inflammatory bowel disease (IBD) patients are at risk for metabolic bone disease, studies analyzing this correlation have identified various risk factors, including disease phenotype, age, sex and steroid therapy. Furthermore, few studies have assessed risk factors for bone loss in Japanese IBD patients. This study analyzed risk factors for metabolic bone disease in Japanese IBD patients. Methods: This cross-sectional study assessed 388 patients with IBD aged 20-50 years, including 232 with ulcerative colitis (UC) and 156 with Crohn's disease (CD). Bone mineral density of the femoral neck, total femur and lumbar spine was quantified by dual-energy X-ray absorptiometry. The blood concentrations of bone metabolism markers were measured. History of smoking and bone fracture, and nutritional intake were assessed using questionnaires. Results: Of the 388 patients with IBD, 78 (20.1%; UC, 17.2%; CD, 24.4%) had osteopenia and 17 (4.4%; UC, 3.4%; CD, 5.8%) had osteoporosis, as assessed by T-score. Bone mineral density of the lumbar vertebrae was lower in males than in females. Multivariate regression analysis showed that risk factors for bone loss in UC patients were male sex, low body mass index (BMI), high steroid dose and disease location. Risk factors for bone loss in CD patients were male sex and low BMI. Conclusion: Among Japanese patients with IBD, male sex and low BMI were associated with increased risk for metabolic bone disease. In addition, Steroid therapy shouldn't be indiscriminate in UC patients. These findings may help identify patients at particularly high risk of metabolic bone disease and may help implement appropriate therapies in a timely manner and improve long-term quality of life.

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KW - Crohn's disease

KW - Inflammatory bowel disease

KW - Japanese

KW - Osteoporosis

KW - Ulcerative colitis

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