Bone mineral density in inflammatory bowel disease

Objective: Inflammatory bowel disease (IBD) is a chronic gastrointestinal system disorder develops a result of chronic inflammation involving various portions and layers of gastrointesinal tractus and presenting remisions and exacerbationsUlcerative colitis (UC), Crohn?s disease (CD) and indeterminate colitis (IC) which can not be distinguished from both are involved in IBD. Factors in genetics, environment and host immune response are responsible for etiology of inflammatory bowel disease IBD is diagnosed by clinical, endoscopic and histologic featuresPatients with IBD have an increased prevalence of reduced bone mineral density (32-77 %) compared with healthy controls. Although the reduced bone mineral density in IBD patients is thought to be related to natural attitude of disease, the use of long-standing and high dose of corticosteroids may play a role in this situation.Material and method: Consecutive 71 IBD patients (21 CD, 50 UC) and 30 healthy controls at gastroenterology department of Cukurova medical faculty are enrolled in this study between 2008-2009 years. Dual energy X-ray absorbtiometry (DEXA) was used to determine bone density and measurements were taken at vertebra and femoral neck. Measurements that were 1 standard deviation below the controls (t score -1SD) were considered as osteopenia and 2.5 standard deviations below the controls ( -2.5) were considered as osteoporosisResults: There is no significant difference between study group and controls according to gender, age and body mass index ( p< 0,05 ). Four of 21 Crohn?s disease patients and twelve of 50 ulcerative colitis patients had active disease. No correlation was found between disease activity and reduced bone mineral density (p> 0.05Bone mineral density measurements in 21 Crohn?s disease patients was found normal in 5 patients (23.8 %), osteopenic in 10 patients (47.6 %) and osteoporotic in 6 patients (28.6 %) These values were significantly reduced when compared healthy controls (p=0.002Bone mineral density measurements in 50 patients with ulcerative colitis revealed normal T scores in 23 patients (46%), osteopenia in 20 patients ( 40%) and osteoporosis in 7 patients(14%). When compared with healthy subjects these results revealed limited significance (p=0.058In the study population four out of twenty-one Crohn?s disease patients and five out of fifty ulcerative colitis patients were taking corticosteroids more than 5 gram totally. There was bone mineral density reduction in these patients but it was not significant (p>0.05)Conclusions: This study revealed significantly higher bone mineral density reduction in IBD patients. This reduction was specially evident in Crohn disease patients. Reduced bone mineral density in patients who were taking corticosteroids more than 5 gram totally was not statistically significant.Keywords: Crohn disease, Ulcerative colitis, DEXA, osteopenia, Osteoporosis.