osteoporosis, corticosteroids and inflammatory bowel disease

Abstract

SUMMARY Osteoporosis is a serious complication of inflammatory bowel disease which has not received adequate recognition despite its high prevalence and potentially devastating clinical effects. Its pathogenesis remains poorly defined although corticosteroid therapy and sex hormone deficiency are likely to play a major role. Recent advances in the diagnosis and management of osteoporosis have facilitated early detection of bone loss and identified means by which this may be prevented. Bone density measurements to predict fracture risk and define thresholds for prevention and treatment should be performed routinely in patients with inflammatory disease. Hormone replacement therapy is effective in prevention of bone loss in peri‐ and post‐menopausal patients, but the treatment of younger women and men of all ages requires further study.

Age-related changes of bone strength phenotypes: observational follow-up study of hand bone mineral density

“…It is unlikely that hand BMD in females increases until the middle of the fifth decade of age, i.e., perimenopausal age. The four-interval model for COMP in females fits well the pattern of remodeling of the bone, as expected from the abundant data from the literature [e.g., 45,46]. As seen in Fig.…”

“…After age 60 the rate of bone loss slows down. Those patterns (four-interval linear model) of age-related changes of hand compacta BMD in women, as well as the pattern of age-related compacta BMD change in men (three-interval model) were almost identical to the pattern of bone mass change described by Compston [45] and by Riggs and Melton [46]. We believe that our present study provides an accurate model of age fitting, because we used a precise method of BMD evaluation and examined a sample with a wide range of ages of individuals measured.…”

Osteoprotegerin and soluble receptor activator of nuclear factor κB ligand in children with inflammatory bowel disease

“…We observed decreased BMD of lumbar spine in 28.5% of children with IBD. This is in agreement with previous studies [20]. Furthermore, we also noted a trend towards lower bone mass in children with CD compared to UC.…”

“…Elevated OPG levels were observed previously in various diseases that are not directly related to bone metabolism [14,16,[20][21][22]. Therefore the question arises whether OPG is a cytokine exclusively involved in bone metabolism or, rather, it is an epitome of the inflammatory or autoimmune process.…”

“…Malabsorption, chronic inflammation, reduced physical activity, delayed puberty and iatrogenic factors -especially of glucocorticoids -are all considered in the pathomechanism of low BMD [20].…”