Bone mineral density is reduced in patients with Crohn's disease but not in patients with ulcerative colitis: a population based study.

Jahnsen, Jørgen; Falch, Jan A.; Aadland, E; Mowinckel, Petter

doi:10.1136/gut.40.3.313

Cited by 244 publications

(200 citation statements)

References 27 publications

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“…In the study by Jahnsen et al, 15 BMD measurements were similar in subjects with colon or ileum involvement. In the same study, no difference in BMD measurements was found in groups with or without small intestinal resection.…”

Section: Discussionmentioning

confidence: 95%

“…Among all patients, 31.0% had osteopenia and 1.4% had osteoporosis. In a study by Jahnsen et al, 15 Z scores for CD patients were lower compared with UC patients and healthy subjects. In the same study, the BMD measurements for UC patients were similar to those of the healthy group.…”

Section: Discussionmentioning

confidence: 99%

“…15 BMI reflects the nutritional status and it has been shown that BMD decreases with decreasing BMI. 16,17 In the Framingham Study of osteoporosis, 17 a negative correlation was detected between BMI and osteoporosis, indicating that the frequency of osteoporosis was lower in subjects with a higher BMI.…”

Section: Discussionmentioning

confidence: 99%

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Relationship between Bone Mineral Density and Clinical Features in Patients with Inflammatory Bowel Disease: A Local Study in Turkish Population

et al. 2010

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This study aimed to compare the bone mineral density (BMD) of patients with ulcerative colitis (UC) and Crohn's disease (CD) in order to determine the possible risk factors for bone loss. A total of 142 patients with UC (n = 88) and CD (n = 54) participated in the study. They were assessed for gender, body mass index (BMI), disease duration and activity, intestinal site of involvement, history of bowel resection, use of steroids, and extraintestinal findings and complications. The BMD was measured by dual-energy X-ray absorptiometry. There were no differences in BMD between UC and CD patients. In UC patients, BMI showed a significant positive correlation with BMD. Femoral neck Z scores were lower in patients with extra-intestinal findings and complications. Steroid use, disease activity, disease localization, disease duration, bowel surgery and gender had no influence on BMD. Complications or extra-intestinal involvement were a significant predictor for BMD in both groups.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Relationship between Bone Mineral Density and Clinical Features in Patients with Inflammatory Bowel Disease: A Local Study in Turkish Population

et al. 2010

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“…(14,15) However, it is not clear whether IBD is a primary risk factor for low BMD and fracture, or whether other factors common in persons with IBD, such as corticosteroid use and low BMI, may predispose to both low BMD and fracture and mediate the effect of IBD on skeletal outcomes. (16,17) Although IBD is not currently considered in the calculation of FRAX when BMD is known, it is considered as a cause of secondary osteoporosis in the calculation of clinical FRAX, even though the evidence supporting a direct effect of IBD on BMD is equivocal. (18,19) Therefore, we sought to determine whether IBD predicts either major osteoporotic fractures (MOF) or hip fractures independent of FRAX probability.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory bowel disease and the risk of fracture after controlling for FRAX

Targownik

Bernstein

Nugent

et al. 2012

Journal of Bone and Mineral Research

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Subjects with inflammatory bowel disease (IBD) are at increased risk for hip and other major osteoporotic fractures. However, previous analyses have not fully accounted for differences in bone mineral density (BMD) and other clinical factors that affect the risk of fracture. The World Health Organization Fracture Risk Assessment tool (FRAX) can be used to predict the 10-year fracture risk from BMD and clinical risk factors. A population-based database containing clinical information on all IBD subjects in the province of Manitoba, Canada, was linked with the Manitoba Bone Mineral Density Database, which contains results of all dual X-ray absorptiometry (DXA) scans in the province. FRAX probabilities were calculated for all subjects aged 50 years or more undergoing baseline DXA testing. Subjects were followed for occurrence of major osteoporotic fractures (MOF; hip, clinical spine, wrist, humerus). Cox proportional hazards models were used to determine whether IBD was independently predictive of MOF or hip fracture. After controlling for FRAX fracture probability computed with BMD, IBD was not associated with a significantly increased risk for MOF (hazard ratio [HR] ¼ 1.12, 95% confidence interval [CI], 0.83-1.55) but was associated with an increased risk for hip fracture (HR ¼ 2.14; 95% CI, 1.26-3.65). The addition of femoral neck T-score to FRAX probability without knowledge of BMD had a negligible effect on the estimated HRs for IBD, suggesting that IBD mediates any effect on fracture risk independently of femoral neck BMD. After controlling for FRAX probability, subjects with IBD are not at an increased risk for overall MOF, but may be at increased risk of hip fracture. ß

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“…While one study found approximately 25% of UC patients to have decreased bone mineral density (BMD), another group in Norway found that unlike CD patients, UC patients had relatively normal body compositions without significantly decreased body mass index (BMI) or BMD (Jahnsen et al, 1997;Jahnsen et al, 2003;Vestergaard, 2004). The exact pathogenesis between UC and metabolic bone disorders is not entirely clear, but suggested causes include nutritional deficiency, malabsorption of calcium and vitamin D, steroid use, immobility, and elevated inflammatory cytokines (Danese, Semeraro et al, 2005).…”

Section: Metabolic Bone Disordersmentioning

confidence: 99%