Bone Fragility in Gastrointestinal Disorders

Merlotti, Daniela; Mingiano, Christian; Valenti, Roberto; Cavati, Guido; Calabrese, Marco; Pirrotta, Filippo; Palazzuoli, Scheme Alberto; Gennari, Luigi

doi:10.3390/ijms23052713

Cited by 14 publications

(9 citation statements)

References 210 publications

(280 reference statements)

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“…It is well known that gastrointestinal diseases, like inflammatory bowel disease (IBD), celiac disease, gastric bypass surgery, and hepatic diseases lead to secondary osteoporosis . 45 – 47 It is very important to recognize secondary osteoporosis since the treatment of these patients may be different; moreover, their therapeutic response may vary, if the underlying disease is not recognized and not treated. According to the article of Mirza et al , 48 “up to 30% of postmenopausal women and 50 to 80% of men are found to have factors contributing to osteoporosis.” Factors contributing to secondary osteoporosis in gastrointestinal diseases include malabsorption, malnutrition, and/or detrimental drug therapy.…”

Section: Discussionmentioning

confidence: 99%

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: Discussionmentioning

confidence: 99%

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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“…Osteoporosis is a common systemic disease or skeletal disorder (10,11). Worldwide, osteoporosis causes millions fracture annually, resulting in an Osteoporotic/fragility fracture (12,13).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Comprehensive Management Protocol for Reduction of the Risk of Fragility Fractures Among Osteoporosis Individuals, Visiting Teaching Hospital, Kolkata

Pal¹,

Adhikari²,

Pal³

2022

MJMHS

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Introduction: Fragility fracture from osteoporosis is a major challenging health problem in aging population in developing countries. In order to reduce the risk of development of osteoporotic fragility fractures authors made a study with high risk individuals, divided into two groups and a comprehensive management protocol had been offered in one group where as conventional management protocol had been offered in other to see the efficacy of such comprehensive management protocol to reduce the risk of occurring fragility fracture over at least three months period among the patients, attended in orthopaedic out patient department of state medical college, West Bengal. Methods: The authors selected 30 diagnosed osteoporosis clients of 50 to 90 years age as per inclusion and exclusion criteria, who attended in orthopaedic OPD in SSKM Hospital, Kolkata, West Bengal, India from 2021April to July2021, carrying highest risk factors of developing osteoporosis. Results: In experimental group, mean post test BMD score is higher than the mean pre test BMD, which is statistically significant as calculated t value is 3.666 at 14 df at 0.05 (p<0.05) level of significances. It indicates that comprehensive management protocol is effective to increase the bone strength. Conclusion: The study of comparison of mean difference values of two groups conclude that comprehensive management protocol can reduce the risk of osteoporotic fracture much efficiently in compared to standard pharmaceutical treatment in a short span of time which is applicable for long term management of osteoporosis.

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“… 1 , 11 Intestinal inflammation, production of pro-inflammatory cytokines, and the presence of neutralising antibodies against osteoprotogerin (OPG) enhance bone absorption, contributing to the decreased BMD that is noted in these patients. 12 , 13 One study exhibited a higher percentage of anti-OPG antibodies in CD patients (10%), compared to the general population. 14 It has been also reported that OPG/RANKL ratio is lower in CD patients, compared to controls, and is positively correlated with spine BMD.…”

Section: Literature Reviewmentioning

confidence: 99%

Musculoskeletal Complications of Celiac Disease: A Case-Based Review

Evangelatos

Kouna

Iliopoulos

et al. 2023

MJR

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Primary diagnosis of celiac disease (CD) in rheumatology department is not common in daily clinical practice, due to the fact that diarrhoea is usually the dominant symptom. Extra-intestinal manifestations, such as arthralgia, myalgia, osteomalacia, and osteoporosis are not rare in these patients. We present a case of a 66-year-old man, who came to the outpatient rheumatology clinic, complaining of back and knee pain. Osteopenia was observed in plain radiographs, whereas extensive laboratory testing revealed celiac disease, vitamin D deficiency, and extremely low bone mineral density (BMD) due to osteomalacia. Gluten-free diet (GFD) initiation and administration of vitamin D and calcium supplements resulted in significant symptom and BMD improvement over 6 months. A significant proportion of CD patients might present with arthralgia, arthritis, back pain, myalgia, or bone pain. Importantly, up to 75% of patients might have reduced BMD, due to osteoporosis or osteomalacia, while they also carry a significant risk for fracture. However, the introduction of GFD and calcium/vitamin D supplementation significantly ameliorates symptoms and BMD in most cases. Increased awareness of CD’s musculoskeletal manifestations by rheumatologists is important for early recognition and management of this condition and its complications.

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Bone Fragility in Gastrointestinal Disorders

Cited by 14 publications

References 210 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

Evaluation of Comprehensive Management Protocol for Reduction of the Risk of Fragility Fractures Among Osteoporosis Individuals, Visiting Teaching Hospital, Kolkata

Musculoskeletal Complications of Celiac Disease: A Case-Based Review

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