Examination of the frequency and associated factors of osteopenia and osteoporosis in inflammatory bowel diseases

Background and Aim: Inflammatory bowel disease (IBD) is a chronic, immune-mediated bowel disease. Patients with IBD may experience extraintestinal symptoms during the disease process. Metabolic bone diseases are one of them. Many factors explain low bone density in IBD. In our study, we aimed to examine the frequency of osteopenia and osteoporosis (OP) in IBD and the demographic, clinical, and laboratory characteristics that may be associated. Methods: In our study, patients diagnosed with IBD clinically, endoscopically and histopathologically were evaluated. One hundred forty-one patients diagnosed with IBD and who had bone mineral density (BMD) measurement with Dual-energy X-ray absorptiometry (DXA) were included in the study. The frequency of OP and the factors that may be associated with osteopenia in IBD were examined by Mann-Whitney-u, T-test, ANOVA, Kruskal-Wallis in continuous variables; Chi-square analysis in categorical variables. p<0.05 was considered significant in all analyses. Results: Of the 141 patients diagnosed with IBD, 67 (47.5%) were diagnosed with Crohn's Disease (CH), and 68 (48.2%) were diagnosed with Ulcerative Colitis (UC). 61 (43.3%) of all IBD patients had osteopenia, and 14 (9.9%) had osteoporosis. Femoral neck BMD averages were significantly lower in women, postmenopausal status, patients with low body mass index (BMI), non-smokers, those with history of surgery, and patients using biological agents. Femoral neck BMD averages were also low in CH patients. There was no correlation between glucocorticoid use, location of disease involvement, and disease activation and osteopenia/OP. Conclusion: OP was more common in patients with female sex, postmenopausal status, and ileum resection, while osteopenia and OP were more common in those with history of surgery. The group with OP is found to have higher levels of inflammatory markers. In addition to the general risk factors in IBD, it is observed that disease-related factors may cause osteopenia/OP. In addition to common risk factors, IBD related risk factors were observed to cause osetopenia/OP. In order to have a more comprehensive idea about osteopenia/OP risk factors in IBD, further studies with higher number of patients and prospective follow-up are required. Keywords: Inflammatory bowel diseases, osteopenia, osteoporosis, femoral neck bone mineral density, L1-L4 lumbar bone mineral density