Risk Factors for Osteoporosis among Patients with Inflammatory Bowel Disease—Do We Already Know Everything?

Abstract

Introduction: There are many known risk factors for osteoporosis (OST) among patients with inflammatory bowel disease (IBD), one of which is physical activity. Material and methods: The aim of the study is to assess the frequency and risk factors of OST among 232 patients with IBD compared to a group of 199 patients without IBD. The participants underwent dual-energy X-ray absorptiometry, laboratory tests, and completed a questionnaire about their physical activity. Results: It was found that 7.3% of IBD patients suffered from OST. Male gender, ulcerative colitis, extensive inflammation in the intestine, exacerbation of disease, rare physical activity, other forms of physical activity, past fractures, lower levels of osteocalcin, and higher levels of C-terminal telopeptide of type 1 collagen were risk factors for OST. As many as 70.6% of OST patients were rarely physically active. Conclusions: OST is a common problem in IBD patients. OST risk factors differ significantly between the general population and those with IBD. Modifiable factors can be influenced by patients and by physicians. The key to OST prophylaxis may be regular physical activity, which should be recommended in clinical remission. It may also prove valuable to use markers of bone turnover in diagnostics, which may enable decisions regarding therapy.

Nutritional Status and Its Detection in Patients with Inflammatory Bowel Diseases

“…Geerling et al [45], Kallel et al [62], and Akbulut et al [63] reported significantly lower serum vitamin B12 concentrations in CD patients compared to HSs. Valentini et al [46] showed similar vitamin B12 deficiencies in CD patients in remission (9.6%) and HSs (0.0%) [30,43]. Contrary to this report, Yakut et al [61] demonstrated a significantly higher rate of vitamin B12 deficiency in CD patients (22.2.%) compared to controls (7.5%) [21,61].…”

“…It is associated with a lower level of osteocalcin, which increases patients' risk for osteoporosis. The correct level of vitamins D and K2 is a perquisite for achieving a higher concentration of osteocalcin [30]. In a study by Lewandowski et al [30], the abovementioned theory was partially supported by the low serum concentration of vitamin D (14.60 ng/mL) [30].…”

“…The authors reported a lower BMI in IBD patients compared to controls (19.8 [13.7-27.5] kg/m 2 vs. 23 [17.9-27.2] kg/m 2 , p < 0.0001). The other anthropometric parameters were also lower in IBD patients compared to the control group, as follows: biceps: 0.3 mm [0.1-1.9] vs. 0.5 mm [0.2-1.0], p < 0.0001; triceps: 0.7 mm [0.2-2.9] vs. 1.2 mm [0.5-2.3], p < 0.0001; skinfold thickness: biceps skinfold (BSF), triceps skinfold (TSF), and mid-arm muscle circumference (MAMC): 25.9 mm [15][16][17][18][19][20][21][23][24][25][26][27][29][30][31][32][33][34][35][36][37] vs. 26.8 mm [24][25][26][27][29][30][31][32][33][34], p < 0.04. Moreover, lower BMI and MAMC scores accompanied by lower serum protein concentration were observed in patients with active disease compared to patients in remission despite comparable daily dietary intake between groups [76].…”

Therapeutic Potential of BMP7 in the Treatment of Osteoporosis Caused by the Interaction between Inflammation and Corticosteroids in Inflammatory Bowel Disease

“…Among various aforementioned complications in IBD, osteoporosis constitutes a significant medical problem with a prevalence of 18 to 42% [ 5 , 6 ]. Osteoporosis is an undesirable condition because it leads to an increased risk of non-traumatic fractures, which are associated with significant morbidity and mortality and impose an additional financial burden on the healthcare system [ 7 ]. The etiology of bone loss in IBD involves several factors that can roughly be divided into a group of variables primarily associated with general skeletal health, such as low mineral intake, decreased vitamin D synthesis, and physical activity, and IBD-associated factors, including harmful effects of prolonged administration of corticosteroids and gastrointestinal damage as a result of an unceasing inflammatory process [ 3 , 8 ].…”

Gene Identification in Inflammatory Bowel Disease via a Machine Learning Approach

“…Nevertheless, environmental factors appear to play a role in the illness. IBD increases the chances of developing other illnesses, such as colorectal cancer [ 7 ] and osteoporosis [ 8 ]. More than 7% of patients with IBD develop osteoporosis [ 8 ].…”