Microscopic Colitis Is Not an Independent Risk Factor for Low Bone Density

Graziano, Elliot; Vaughn, Byron P.; Wang, Qi; Chow, Lisa S.; Campbell, James P.

doi:10.1007/s10620-020-06651-2

Cited by 2 publications

(20 citation statements)

References 23 publications

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“…Budesonide therapy was prescribed in 58% of the MC patients as intermittent use while 30% of them received it as maintenance treatment. Although we have no data on the use of budesonide in the article of Graziano et al, 36 10.6% of the MC patients received steroid therapy for more than 3-month 37 ; however, 79.3% of them have been treated with budesonide in the past, at least 6 weeks before enrollment and for a shorter period than 8 weeks. In the article of Greenberg and Yen, 38 more than two-thirds of the MC patients were treated with budesonide, while no data are available on any other type of steroid use among the MC patients.…”

Section: Included Studies' Characteristicsmentioning

confidence: 81%

“…3046 records were scrutinized and assessed for eligibility. After screening records identified in five databases, the number of reports assessed for eligibility was 10, 11,[36][37][38][39][40][41][42][43][44] and eventually, three fulltext articles 11,36,37 and one conference abstract 38 were chosen for analysis.…”

Section: Systematic Search and Selectionmentioning

confidence: 99%

“…Quantitative synthesis MC as a risk factor for LBD. We included all four articles 11,[36][37][38] into our quantitative synthesis. Each of them used age-and sex-matched controls to evaluate LBD occurrence in patients with MC.…”

Section: Included Studies' Characteristicsmentioning

confidence: 99%

“…MC as a risk factor for osteopenia. Three studies 11,36,37 reported the presence of osteopenia in patients with MC compared to age-and sexmatched controls. Altogether 111 patients with MC were examined, 54 had osteopenia among them, while in the case of the controls, 87 suffered from osteopenia out of 265.…”

Section: Included Studies' Characteristicsmentioning

confidence: 99%

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Microscopic colitis is a risk factor for low bone density: a systematic review and meta-analysis

Rancz

Teutsch

Engh

et al. 2023

Therap Adv Gastroenterol

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Background: Microscopic colitis (MC) is a chronic inflammatory disease of the large bowel characterized by watery diarrhea, substantially decreasing the patient’s quality of life. Scarce data suggest that MC is associated with low bone density (LBD). Objectives: We aimed to assess whether MC is a risk factor for LBD and the proportion of patients with MC having LBD. Design: A systematic review and meta-analysis of studies reporting bone density measurements in MC patients. Data Sources and Methods: We systematically searched five databases from inception to October 16, 2021 (Pubmed, Embase, Cochrane, Scopus, and Web of Science). We used the random-effect model to calculate pooled odds ratios (ORs) and pooled event rates with 95% confidence intervals (CIs). To ascertain the quality of evidence of our outcomes, we followed the recommendations of the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Working Group. Results: The systematic search yielded a total of 3046 articles. Four articles were eligible for quantitative synthesis. All of them used age- and sex-matched controls to evaluate LBD occurrence among patients with MC. The odds of having LBD were twofold increased (OR = 2.13, CI: 1.42–3.20) in the presence of MC, the odds of osteopenia occurrence were 2.4 (OR = 2.45, CI: 1.11–5.41), and of osteoporosis 1.4 (OR = 1.42, CI: 0.65–3.12). The proportion of LBD was 0.68 (CI: 0.56–0.78), osteopenia was 0.51 (CI: 0.43–0.58), and osteoporosis was 0.11 (CI: 0.07–0.16) among the MC population. Our findings’ certainty of the evidence was very low following the GRADEPro guideline. Conclusion: Our data demonstrate that MC is associated with a twofold risk for LBD. Based on our findings, we suggest screening patients for bone mineral density upon diagnosis of MC. Further prospective studies with higher patient numbers and longer follow-up periods on this topic are needed. Registration: Our protocol was prospectively registered with PROSPERO (CRD42021283392).

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Section: Included Studies' Characteristicsmentioning

confidence: 81%

Section: Systematic Search and Selectionmentioning

confidence: 99%

Section: Included Studies' Characteristicsmentioning

confidence: 99%

Section: Included Studies' Characteristicsmentioning

confidence: 99%

See 2 more Smart Citations

Microscopic colitis is a risk factor for low bone density: a systematic review and meta-analysis

Rancz

Teutsch

Engh

et al. 2023

Therap Adv Gastroenterol

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“…Although the nature and prognosis of SCAD are different from IBD, the clinical symptoms and the pathogenesis are similar [16]. The incidence of MC is similar to classic IBD and is considered the prelude to IBD or a subtype of IBD by some experts [18, 33]. MC also shares common mechanisms with IBD pathogenesis and patients with MC have an increased risk of developing IBD [17, 34].…”

Section: Discussionmentioning

confidence: 99%

Chronic Inflammatory Intestinal Disorders in Hidradenitis Suppurativa

et al. 2023

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Background: Intestinal symptoms are common in patients with hidradenitis suppurativa (HS). HS patients may experience a broad spectrum of chronic inflammatory intestinal disorders (CIID), not exclusive to inflammatory bowel diseases, which are diagnosed by colonoscopy and intestinal biopsies. The frequency of CIID in patients with HS has not been investigated. Objective: The objectives of this study were to determine the occurrence of CIID in HS and characterise this clinical population. Furthermore, the feasibility of using fecal calprotectin (FC) test or anti-Saccharomyces cerevisiae antibody (ASCA) levels to assess the colonic inflammation of CIID in HS patients was investigated. Methods: All newly diagnosed and untreated HS patients (n=74) were referred to a gastroenterologist for FC followed by colonoscopy after informed consent. C-reactive protein (CRP), white blood cell count, nucleotide-binding-oligomerisation-domain-containing-protein-2 (NOD2) polymorphism, and ASCA levels were measured. Patients were divided into HS-only and HS with CIID (HS+CIID) groups, based on the absence or presence of CIID. Laboratory and clinical parameters (age, gender, HS onset, clinical stage, family history, body mass index (BMI), smoking) were compared between the groups. Results: Thirteen patients complained gastrointestinal symptoms prior to any examination, including 11 in the HS+CIID group. The CIID frequency in HS was 28.4% (n=21/74), based on colonoscopy and histology. Significantly more patients had severe disease state in the HS+CIID group compared with the HS-only group, and BMI was significantly lower in the HS+CIID group (28.20±5.58 vs. 32.74±6.45, p=0.006). FC positivity occurred significantly more in HS+CIID patients compared with HS-only patients (90.48% vs. 3.77%, p<0.001), and ASCA IgG levels were significantly elevated in HS+CIID patients (22.08±23.07 vs 8.41±10.94 U/mL, p=0.001). The FC test identified HS+CIID patients with 96.23% specificity and 91.3% sensitivity, while ASCA displayed 77.8% sensitivity and 76.3% specificity. Blood count, CRP and the presence of NOD2 polymorphisms were indifferent between the two groups. Conclusion: A high frequency of CIID was detected in the examined HS population. The non-invasive FC test has high sensitivity and specificity for diagnosing CIID in HS patients. Concomitant CIID and HS may indicate the need for an early-start for biological treatment.

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Microscopic Colitis Is Not an Independent Risk Factor for Low Bone Density

Cited by 2 publications

References 23 publications

Microscopic colitis is a risk factor for low bone density: a systematic review and meta-analysis

Microscopic colitis is a risk factor for low bone density: a systematic review and meta-analysis

Chronic Inflammatory Intestinal Disorders in Hidradenitis Suppurativa

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