Frequency of low bone mineral density in Saudi patients with inflammatory bowel disease

Abstract

Background/Aims:Metabolic bone disease is common in patients with inflammatory bowel disease (IBD). Our aim was to determine the frequency of bone loss among Saudi patients with IBD and possible contributing risk factors.Settings and Design:We retrospectively reviewed Saudi patients with IBD, between 18 and 70 years of age, who had bone mass density (BMD) determined by dual-energy X-ray absorptiometry scanning at one of three hospitals in the Kingdom of Saudi Arabia from 2001 to 2008.Patients and Methods:Case notes and BMDs results were carefully reviewed for demographic and clinical data. Low bone mass, osteopenia, and osteoporosis were defined according to the WHO guidelines.Statistical Analysis Used:Predictive factors for BMD were analyzed using group comparisons and stepwise regression analyses.Results:Ninety-five patients were included; 46% had Crohn's disease (CD) and 54% had ulcerative colitis (UC). The average age was 30.9±11.6 years. Using T-scores, the frequency of osteopenia was 44.2%, and the frequency of osteoporosis was 30.5% at both lumbar spine and proximal femur. Only 25.3% of patients exhibited a BMD within the normal range. Our results revealed a positive correlation between the Z-score in both the lumbar spine and the proximal femur and body mass index (BMI) (P=0.042 and P=0.018, respectively). On regression analysis BMI, age, and calcium supplementation were found to be the most important independent predictors of BMD.Conclusions:Saudi patients with IBD are at an increased risk of low BMD and the frequency of decreased BMD in Saudi patients with CD and UC were similar. BMI and age were the most important independent predictors of low BMD.

Risk Factors for Low Bone Density in Inflammatory Bowel Disease: Use of Glucocorticoids, Low Body Mass Index, and Smoking

“…In summary, the current study demonstrates rates of decreased BMD similar to those seen in previous studies in Middle Eastern populations [15,36]. Decreased bone density was associated with well-known risk factors (lower BMI, glucocorticoids use) but not with NOD2 genetic mutations.…”

“…Low bone density is a well-recognized complication in IBD patients and was demonstrated in this study in similar rates to previous studies (up to 20% osteoporosis and 60% osteopenia) [3,15,16]. Nevertheless, data regarding risk factors for this complication in this population are limited.…”

“…The relation between 25OHD status and BMD, which is well established in menopausal women, is controversial in IBD patients, with studies [15,18,32] supporting the claim while others [33][34][35] refute it. In our cohort, 42% of patients were treated with 25OHD at the time of BMD assessment, 63% of which had been treated for less than 3 months.…”

La baisse de la densité osseuse au cours des maladies inflammatoires chroniques de l’intestin : prévalence et facteurs de risque

“…La perte osseuse apparaît actuellement comme une complication importante et souvent silencieuse des maladies digestives, qui aggrave leur morbidité et altère davantage la qualité de vie des patients [2]. La fracture est la seule complication cliniquement importante de l′ostéoporose, et le risque fracturaire dans l'ostéoporose des patients avec MICI est clairement établi dans la littérature.…”

Epidemiology and awareness of osteoporosis: a viewpoint from the Middle East and North Africa

“…Prevalence of osteopenia and OP in adult Saudi patients with inflammatory bowel disease (IBD) was relatively low compared to worldwide reports [91]. IBD patients are at an increased risk of low BMD and the BMI, age and calcium supplements were independent predictors [92]. OP and osteopenia are noticed with a respective frequency of 35.7% and 23.2% in Crohn's disease (CD).…”