Inflammatory Bowel Disease and Risk of Osteoporotic Fractures: A Meta-Analysis

Hidalgo, Diego; Boonpheng, Boonphiphop; Phemister, Jennifer; Young, Mark

doi:10.14309/00000434-201810001-00637

Cited by 4 publications

(5 citation statements)

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“…Sheth et al found that the prevalence of osteopenia ranges from 32 to 36% and osteoporosis from 7 to 15% ( 2 ). Fracture risk is higher in these patients than in healthy subjects, according to a recent meta-analysis showing a 32% increased risk, which is consistent with different cohort studies previously conducted ( 3 ). Many factors are associated with decreased BMD, one of which is the use of high-dose glucocorticoids.…”

Section: Introductionsupporting

confidence: 90%

Lean mass, magnesium, faecal calprotectin and glucocorticoid exposure as risk factors for low bone mineral density in inflammatory bowel disease patients

Soare

Sîrbu

Diculescu

et al. 2021

Endocrine Connections

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Background and aims: Low bone mineral density (BMD) is a common complication in patients with inflammatory bowel disease (IBD). However, debates are ongoing with regard to the other involved factors, especially in younger patients. This study aimed to evaluate the parameters that contribute to decreased BMD, focusing on premenopausal women and men aged <50 years. Methods: This study has evaluated 81 patients with IBD and 81 age-, sex- and body mass index (BMI)-matched controls. Blood tests were conducted on IBD patients, and dual-energy X-ray absorptiometry (DXA) scan was performed on both groups. Results: Low BMD and fragility fracture were found to be more prevalent in IBD patients than in healthy subjects (49.3% vs 23.4%, p = 0.001 and 9.8% vs 1.2%, p = 0.01, respectively). Patients with low BMD were older, with a longer disease duration, higher faecal calprotectin (FC) level and lower magnesium and lean mass (appreciated as appendicular skeletal muscle index (ASMI)). Multiple regression analysis revealed that ASMI, age and use of glucocorticoids were independent parameters for decreased BMD. Although 91.3% of the patients had a 25-hydroxy vitamin D level of <30 ng/mL, it was not a statistically significant factor for decreased BMD. Conclusion: In our study, the levels of vitamin D did not seem to have an important impact on BMD. Conversely, FC, magnesium and lean mass are important factors, suggesting that good control of disease, adequate magnesium intake and increased lean mass can have a good impact on bone metabolism in patients with IBD.

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Section: Introductionsupporting

confidence: 90%

Lean mass, magnesium, faecal calprotectin and glucocorticoid exposure as risk factors for low bone mineral density in inflammatory bowel disease patients

Soare

Sîrbu

Diculescu

et al. 2021

Endocrine Connections

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“…The Newcastle-Ottawa scale (Figure 1 ) was used by the investigators independently to determine the quality of each study. This scale evaluates each study in terms of participants selection (minimum score is 0; maximum is 4), comparability (minimum score is 0; maximum is 2), and the ascertainment of the exposure of interest for case-control studies, and the outcome of interest for cohort studies (minimum score is 0; maximum is 3) [ 13 , 14 , 15 ]. Newcastle-Ottawa scale contains eight items within three domains and the total maximum score is 9.…”

Section: Methodsmentioning

confidence: 99%

“…Cochran's Q test and I2 statistic were used to determine the between-study heterogeneity. A value of I2 of 0%-25% represents insignificant heterogeneity, greater than 25% but less than or equal to 50% represents low heterogeneity, greater than 50% but less than or equal to 75% represents moderate heterogeneity, and greater than 75% represents high heterogeneity [ 14 , 15 ].…”

Section: Methodsmentioning

confidence: 99%

Chronic Liver Disease and the Risk of Osteoporotic Fractures: A Meta-Analysis

Hidalgo

Boonpheng

Sikandar

et al. 2020

Cureus

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Introduction Chronic liver disease (CLD) causes more than 1 million deaths every year and remains a pandemic in the last decade affecting more than 600,000 patients in the United States. Previous studies found patients with CLD had increased risk of osteoporosis, so fractures were inferred to be complications of this condition. The aim of this meta-analysis is to summarize the best evidence that correlates CLD patients and the risk to develop osteoporotic fractures versus control patients without CLD. Methods A review of the literature using MEDLINE and EMBASE database was performed during December 2017. We included cross-sectional and cohort studies that reported relative risks (RR), odds ratios (OR) and hazard ratios (HR) comparing the risk of developing osteoporotic fractures among patients with CLD versus patients without CLD. Pooled OR and 95% confidence interval (CI) were calculated using generic inverse-variance method. The Newcastle-Ottawa scale was used to determine the quality of the studies. Effect estimates from the individual study were extracted and combined using the random-effect, generic inverse variance method of DerSimonian and Laird. Results After the review of the literature, seven studies fulfilled the eligibility criteria established during the analysis. Significant association was found between CLD and osteoporotic fractures with a pooled OR of 2.13 (95% CI, 1.79-2.52). High heterogeneity among the studies was found (I2=88.5). No publication bias was found using Egger regression test (p=0.44). Conclusion We found a significant association between CLD and the risk of developing osteoporotic fractures. The calculated risk was 2.13 times higher for patients with CLD when compared with controls. The results showed high heterogeneity but no publication bias. More prospective studies are needed to fully understand the mechanisms involved in loss of bone density and osteoporotic fractures in order to improve the morbidity associated with this disease.

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“…[2][3][4][5] Roughly half of all patients with inflammatory bowel disease (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), exhibit a significant reduction in bone mass during the course of their chronic inflammatory disease and are thus at an elevated risk of osteoporotic fractures relative to healthy individuals. [6][7][8] Prior work has firmly established the relationship between inflammatory activity and bone loss. 9 Skeletal tissue remodelling processes are governed by osteoblasts (OBs) and osteoclasts (OCLs), which are respectively responsible for bone formation and resorption.…”

Section: Introductionmentioning

confidence: 99%