Risk factors for metabolic bone disease in Crohn's disease patients

Background: The aim was to evaluate the presence of metabolic bone disease (MBD) in patients with Crohn's disease (CD) and to identify potential etiologic factors. Methods: The case–control study included 99 patients with CD and 56 controls with a similar age and gender distribution. Both group...

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Published in:Inflammatory bowel diseases 2010-12, Vol.16 (12), p.2117-2124
Main Authors: Cravo, Marília, Guerreiro, Catarina Sousa, dos Santos, Paula Moura, Brito, Miguel, Ferreira, Paula, Fidalgo, Catarina, Tavares, Lourdes, Pereira, António Dias
Format: Article
Language:English
Subjects:
Adult
Age
Age composition
Body Composition
Body Mass Index
Bone Density
Bone diseases
Bone Diseases, Metabolic - etiology
Bone Diseases, Metabolic - pathology
Case-Control Studies
Computer programs
Crohn Disease - complications
Crohn Disease - pathology
Crohn Disease - therapy
Crohn's disease
etiologic factors
Female
Humans
Inflammatory bowel diseases
Interleukin 1
Interleukin 6
Interleukin-1 - genetics
Interleukin-6 - genetics
Intestine
Ionizing radiation
Low fat diet
Male
metabolic bone disease
Nutrient deficiency
Osteoporosis
Polymorphism, Genetic - genetics
Regression analysis
Risk Factors
Single-nucleotide polymorphism
software
Statistical analysis
Steroid hormones
Treatment Outcome
Tumor Necrosis Factor-alpha - genetics
Vitamin K
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Summary:Background: The aim was to evaluate the presence of metabolic bone disease (MBD) in patients with Crohn's disease (CD) and to identify potential etiologic factors. Methods: The case–control study included 99 patients with CD and 56 controls with a similar age and gender distribution. Both groups had dual‐energy x‐ray absorptionmetry and a nutritional evaluation. Single nucleotide polymorphisms at the IL1, TNF‐α, LTα, and IL‐6 genes were analyzed in patients only. Statistical analysis was performed using SPSS software. Results: The prevalence of MBD was significantly higher in patients (P = 0.006). CD patients with osteoporosis were older (P < 0.005), small bowel involvement and surgical resections were more frequent (P < 0.005), they more often exhibited a penetrating or stricturing phenotype (P < 0.05), duration of disease over 15 years (P < 0.005), and body mass index (BMI) under 18.5 kg/m2 (P < 0.01) were more often found. No association was found with steroid use. Patients with a Z‐score < −2.0 more frequently had chronic active disease (P < 0.05). With regard to diet, low vitamin K intake was more frequent (P = 0.03) and intake of total, monounsaturated, and polyunsaturated fat was higher in patients with Z‐score < −2.0 (P < 0.05). With respect to genetics, carriage of the polymorphic allele for LTα252 A/G was associated with a higher risk of osteoporosis (P = 0.02). Regression analysis showed that age over 40 years, chronic active disease, and previous colonic resections were independently associated with the risk of developing MBD. Conclusions: The prevalence of MBD was significantly higher in CD patients. Besides the usual risk factors, we observed that factors related to chronic active and long‐lasting disease increased the risk of MBD. (Inflamm Bowel Dis 2010)
ISSN:1078-0998
1536-4844
1536-4844
DOI:10.1002/ibd.21297