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

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.

[1]  A. Zawada,et al.  The associations between vitamin D, bone mineral density and the course of inflammatory bowel disease in Polish patients. , 2022, Polish archives of internal medicine.

[2]  G. Rydzewska,et al.  Bone Metabolism Alteration in Patients with Inflammatory Bowel Disease , 2022, Journal of clinical medicine.

[3]  J. Reguła,et al.  Guidelines for the management of patients with Crohn’s disease. Recommendations of the Polish Society of Gastroenterology and the Polish National Consultant in Gastroenterology , 2021, Przeglad gastroenterologiczny.

[4]  A. Rychter,et al.  Associations of Lifestyle Factors with Osteopenia and Osteoporosis in Polish Patients with Inflammatory Bowel Disease , 2021, Nutrients.

[5]  D. Mellström,et al.  Physical exercise is associated with beneficial bone mineral density and body composition in young adults with childhood-onset inflammatory bowel disease , 2021, Scandinavian journal of gastroenterology.

[6]  F. Bendtsen,et al.  Systematic review of the prevalence and development of osteoporosis or low bone mineral density and its risk factors in patients with inflammatory bowel disease , 2020, World journal of gastroenterology.

[7]  N. Watts,et al.  AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS/AMERICAN COLLEGE OF ENDOCRINOLOGY CLINICAL PRACTICE GUIDELINES FOR THE DIAGNOSIS AND TREATMENT OF POSTMENOPAUSAL OSTEOPOROSIS-2020 UPDATE. , 2020, Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists.

[8]  G. Scambia,et al.  Role of vitamin K2 in bone metabolism: a point of view and a short reappraisal of the literature , 2019, Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology.

[9]  C. Cooper,et al.  Executive summary of the European guidance for the diagnosis and management of osteoporosis in postmenopausal women , 2019, Calcified Tissue International.

[10]  A. Moss,et al.  Vitamin D in inflammatory bowel disease: more than just a supplement , 2018, Current opinion in gastroenterology.

[11]  G. Rogler,et al.  Widely differing screening and treatment practice for osteoporosis in patients with inflammatory bowel diseases in the Swiss IBD cohort study , 2017, Medicine.

[12]  A. Lyra,et al.  Risk factors for osteoporosis in inflammatory bowel disease patients. , 2015, World journal of gastrointestinal pathophysiology.

[13]  N. Yurgin,et al.  Cost Effectiveness of Denosumab versus Oral Bisphosphonates for Postmenopausal Osteoporosis in the US , 2013, Applied Health Economics and Health Policy.

[14]  E. Małecka-Panas,et al.  Guidelines for the management of ulcerative colitis. Recommendations of the Working Group of the Polish National Consultant in Gastroenterology and the Polish Society of Gastroenterology , 2012 .

[15]  J. Callejas-Rubio,et al.  [Vitamin D deficiency and bone mineral density in Crohn's disease]. , 2011, Medicina clinica.

[16]  G. Radford-Smith,et al.  Body composition and muscle strength as predictors of bone mineral density in Crohn’s disease , 2009, Journal of Bone and Mineral Metabolism.

[17]  M. Koršić,et al.  Proinflammatory cytokines and receptor activator of nuclear factor κB-ligand/osteoprotegerin associated with bone deterioration in patients with Crohn's disease , 2009, European journal of gastroenterology & hepatology.

[18]  W. Leslie,et al.  Vitamin D Status and Bone Density in Recently Diagnosed Inflammatory Bowel Disease: The Manitoba IBD Cohort Study , 2008, The American Journal of Gastroenterology.

[19]  D. Armstrong,et al.  Evaluation of densitometric bone-muscle relationships in Crohn's disease. , 2007, Bone.

[20]  E. Vasiliauskas,et al.  Measurement of vitamin D levels in inflammatory bowel disease patients reveals a subset of Crohn’s disease patients with elevated 1,25-dihydroxyvitamin D and low bone mineral density , 2004, Gut.

[21]  J. Sanderson,et al.  Bone density improves with disease remission in patients with inflammatory bowel disease , 2003, European journal of gastroenterology & hepatology.

[22]  Peter Vestergaard,et al.  Fracture risk in patients with celiac Disease, Crohn's disease, and ulcerative colitis: a nationwide follow-up study of 16,416 patients in Denmark. , 2002, American journal of epidemiology.

[23]  H. Bitter,et al.  Bone density reduction in patients with Crohn disease and associations with demographic and disease variables: cross-sectional data from a population-based study. , 2001, Scandinavian journal of gastroenterology.

[24]  L. Schurgers,et al.  Abnormal bone turnover in long‐standing Crohn’s disease in remission , 2001, Alimentary pharmacology & therapeutics.

[25]  S. Laurberg,et al.  Fracture risk is increased in Crohn's disease, but not in ulcerative colitis , 2000, Gut.

[26]  G. Porro,et al.  Altered bone metabolism in inflammatory bowel disease: there is a difference between Crohn’s disease and ulcerative colitis , 2000, Journal of internal medicine.

[27]  Z. Tulassay,et al.  Altered Bone Metabolism in Inflammatory Bowel Disease , 1998, American Journal of Gastroenterology.

[28]  J. Jahnsen,et al.  Bone mineral density is reduced in patients with Crohn's disease but not in patients with ulcerative colitis: a population based study. , 1997, Gut.

[29]  M. Manns,et al.  Altered bone metabolism in inflammatory bowel disease. , 1997, The American journal of gastroenterology.

[30]  F. Kaplan,et al.  Prevention and management of osteoporosis. , 1995, Clinical symposia.

[31]  B. Creamer,et al.  Plasma levels and intestinal absorption of 25-hydroxyvitamin D in patients with small bowel resection. , 1977, Gut.