High prevalence of fractures in Brazilian patients with inflammatory bowel disease: lack of association with bone mass density and quantitative ultrasound measurements

Abstract

To investigate the impact of inflammatory bowel disease (IBD) on bone status, a cross-sectional study was conducted including 102 Brazilian patients with ulcerative colitis or Crohn's disease. Our results demonstrated the higher prevalence of low bone mass and fragility fractures in Brazilian patients compared with other populations with IBD. Introduction The prevalence of low bone mass and fractures in Brazilian patients with Crohn's disease (CD) and ulcerative colitis (UC) was investigated. Methods Patients with CD or UC answered a questionnaire detailing clinical risk factors for fracture. Bone mineral density (BMD) and quantitative ultrasound (QUS) measurements were performed in all patients. Spine X-ray was performed to determine the prevalence of vertebral fractures. Non-vertebral fracture data were obtained from medical history. Results A total of 61 women and 41 men (mean age 41.2 years) were included. Fractures were observed in 40.8% and 33.3% of the UC and CD patients respectively. 31.9% and 7.2% of the patients had vertebral and nonvertebral fractures respectively. Weight and body mass index were higher in patients with fracture than in those without (p<0.01), while other clinical variables did not differ significantly between groups. Densitometric osteoporosis was detected in 14.7% of the population. Osteoporosis was more prevalent among men than women (p=0.014). CD patients had significantly lower BMD values than UC patients. BMD and QUS values were not associated with fractures. Conclusion We observed a high prevalence of vertebral fractures (37.1%) in a young Brazilian IBD population. BMD and QUS were not associated with fracture in these patients.