Avaliação da densidade mineral óssea em pacientes com doença inflamatória intestinal

Lora, Fabiana Lígia; Amarante, Heda Maria Barska dos Santos; Pisani, Júlio César; Borba, Victória V. C.; Kulak, Carolina A. M.; Carmes, Eliane Ribeiro

doi:10.1590/s0004-28032005000400003

Cited by 9 publications

(5 citation statements)

References 29 publications

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“…1,12,15 Two of the female patients with CD with a history of fracture were perimenopausal, another contributing factor to bone loss. 9,10 Among the patients with UC, only one was menopaused and presented normal BMD.…”

Section: Discussionmentioning

confidence: 99%

“…Low BMD in this group of patients is more frequent than in the general population 1 and factors such as chronic inflammation, prolonged use of corticosteroids, unsatisfactory physical activity, and malnutrition may contribute to the appearance and aggravation of the condition. 2,3 In addition, the absorptive changes that patients with IBD present may cause vitamin D absorption deficits.…”

Section: Introductionmentioning

confidence: 91%

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Alert for bone alterations and low serum concentrations of vitamin D in patients with intestinal inflammatory disease

Kotze

Costa

Cavassani

et al. 2017

Rev. Assoc. Med. Bras.

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Background: Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are characterized by chronic inflammation of the intestine that can reduce the absorption of nutrients such as vitamin D and calcium. Objective: To investigate bone alterations and serum levels of vitamin D in patients with IBD. Method: This was a cross-sectional study based on a review of medical records of patients from a private office in Curitiba, PR, Brazil. Serum levels of vitamin D and bone densitometry were measured at diagnosis of IBD. A total of 105 patients were included; 38 (58.4%) with CD; 27 (41.6%) with UC and 40 with irritable bowel syndrome (IBS) as comparison group. Results: When compared to patients with UC, CD patients showed a higher prevalence of bone alterations, being 15.8% with osteoporosis and 36.8% with osteopenia. In UC, bone alterations occurred in 29.6% of cases, 3.7% with osteoporosis and 25.9% with osteopenia. As for vitamin D levels, among CD patients, 10.5% had vitamin deficiency, 65.8% insufficiency and 23.7% were sufficient. In UC, 7.4% of cases had deficiency, 74.1% insufficiency and 18.5% had sufficient serum levels of vitamin D. In the group with IBS, deficiency was observed in 17.5% of cases, insufficiency in 55% and sufficiency in 27.5% of them. There was no significant difference between groups. Conclusion: IBD patients have a high prevalence of bone changes, especially those with CD. Serum levels of vitamin D are below the recommended in all the evaluated groups.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 91%

Alert for bone alterations and low serum concentrations of vitamin D in patients with intestinal inflammatory disease

Kotze

Costa

Cavassani

et al. 2017

Rev. Assoc. Med. Bras.

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“…Decreased bone mass is observed in up to 50% of patients with celiac disease and 41% with Crohn's disease [13,14]. The development of osteoporosis after the surgical removal of the stomach was documented decades ago by epidemiological and experimental approaches as well as clinical observations, thereby laying the basis for a relationship between the stomach and bone metabolism [15][16][17].…”

Section: Discussionmentioning

confidence: 99%

Chronic Gastritis and Bone Mineral Density in Women

Kakehasi

Rodrigues²,

Carvalho³

2008

Dig Dis Sci

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We conducted a cross-sectional study of bone mineral density in women with Helicobacter pylori gastritis or autoimmune gastritis. Eighty-five patients were enrolled: 24 patients (mean age 55.2 +/- 13.5 years) with autoimmune gastritis, 34 patients (mean age 63.7 +/- 7.3 years) with H. pylori gastritis, and 27 H. pylori-negative patients with normal gastric mucosa (mean age 62.5 +/- 7.0 years). Gastric mucosa was evaluated by histology and immunohistochemistry. Bone mineral density was measured by dual-energy X-ray absorptiometry. Autoimmune gastritis patients presented severe gastric body mucosa atrophy, based on the absence of parietal cells in 15 (62.5%) patients and the presence of only scattered parietal cells in the remaining nine (37.5%) patients. Among the H. pylori gastritis patients, 21 (62%) presented with different degrees of gastric mucosa atrophy. Bone mineral densities (mean +/- SD, g/mm(2)) were not different among patients with autoimmune gastritis and H. pylori gastritis and the controls. Our results suggest that H. pylori-associated gastritis and autoimmune gastritis would not to be risk factors for decreased bone mineral density in women.

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“…Besides, other risk factors are involved such as age-related conditions, genetic background, environmental pitfalls, chronic diseases, and physical characteristics of bone. Among gastrointestinal diseases inflammatory bowel disease, celiac disease and gastrectomy are associated with osteoporosis (3,7,13,24,25,30) . Gastrectomy is recognized as a risk factor for osteoporosis and patients submitted to this surgical procedure present a higher incidence of fractures (4,26,40) .…”

Section: Introductionmentioning

confidence: 99%

The presence of Helicobacter Pylori in postmenopausal women is not a factor to the decrease of bone mineral density

Kakehasi

Mendes

Coelho

et al. 2007

Arq. Gastroenterol.

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-Background -Osteoporosis affects approximately 30% of postmenopausal women. Gastrectomy, pernicious anemia, and more recently Helicobacter pylori infection, have all been implicated in the pathogenesis of osteoporosis. A reduced parietal cell mass is a common feature in these conditions. Aim -To study a possible relationship between chronic gastritis, parietal cell density of the oxyntic mucosa and bone mineral density in postmenopausal women, as chronic gastritis, Helicobacter pylori infection and osteoporosis are frequently observed in the elderly. Methods -Fifty postmenopausal women (61.7 ± 7 years) were submitted to gastroduodenal endoscopy and bone densitometry by dual energy X-ray absorptiometry. Glandular atrophy was evaluated objectively by the determination of parietal cell density. Helicobacter pylori infection was evaluated by histology, urease test and breath test with 13 C. Results -Thirty-two patients (64%) presented chronic multifocal gastritis, and 20 of them (40%) showed signs of gastric mucosa atrophy. Lumbar spine osteoporosis was found in 18 patients (36%). The parietal cell density in patients with and without osteoporosis was 948 ± 188 and 804 ± 203 cells/mm 2 , respectively. Ten osteoporotic patients (55%) and 24 non-osteoporotic patients (75%) were infected by Helicobacter pylori. Conclusion -Postmenopausal women with osteoporosis presented a well-preserved parietal cell density in comparison with their counterparts without osteoporosis. Helicobacter pylori infection was not different between the two groups. We concluded that neither atrophic chronic gastritis nor Helicobacter pylori seem to be a reliable risk factor to osteoporosis in postmenopausal women. HEADINGS -Postmenopause. Osteoporosis, postmenopausal. Gastritis. Helicobacter infections.

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Avaliação da densidade mineral óssea em pacientes com doença inflamatória intestinal

Cited by 9 publications

References 29 publications

Alert for bone alterations and low serum concentrations of vitamin D in patients with intestinal inflammatory disease

Alert for bone alterations and low serum concentrations of vitamin D in patients with intestinal inflammatory disease

Chronic Gastritis and Bone Mineral Density in Women

The presence of Helicobacter Pylori in postmenopausal women is not a factor to the decrease of bone mineral density

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