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P119. Bone mineral density in Portuguese patients with Crohn's disease

R. Cerqueira1, M.C. Manso2, C. Fernandes1, M. Correia1

1Gastroenterology, S Sebastião Hospital, Santa Maria Feira, Portugal; 2Biostatistics, Fernando Pessoa University e Requimte, Porto, Portugal

Aims: High prevalence rates of decreased bone mineral density (BMD) in patients with Crohn's disease (CD) have been reported in several studies. However, in Portugal there is no data regarding this association.

The aim of this study is to determine the prevalence of decreased BMD and related clinical risk factors in Portuguese CD patients.

Materials and Methods: Dual-energy X-ray absorptiometry technique was used to measure BMD at the lumbar spine (LS) and femoral neck (FN). The level of statistical significance was set at p < 0.05. Stepwise multivariate logistic regression analysis was used to find predictive factors for decreased BMD.

Results: One-hundred one consecutive CD adult patients were recruited into the study (mean age ± standard deviation of 34.6±10.9 years) with 47.6±56.9 months of disease's duration, 54 (53.5%) of which were males. Thirty-two (31.6%) patients were smokers, 36 patients (35.6%) were steroid users, 24 (24.2%) had low body mass index (<20) and 20 patients (19.8%) were submitted to small bowel surgery. Thirty six (35.6%) patients were Montreal L1, 19 (18.8%) patients were Montreal L2 and 46 (45.5%) patients were Montreal L3. The prevalence of osteopenia (T score between −1 and −2.5) was 37.6% at LS and 26.7% at FN. The prevalence (95% CI) of osteoporosis was 4% (1.1%-9.8%) at LS and 2% (0.2%-7.0%) at FN, assessed by WHO classification, and 5% (1.6%-11.2%) at LS and 3% (0.6%-8.4%) at FN assessed by ECCO consensus definition. Mean T scores were −0.57±1.27 at LS and −0.30±1.17 at FN. Mean Z scores were −0.37±1.20 at LS and −0.09±1.07 at FN. Univariate analysis of LS T scores identified age (higher than 40 years) as risk factor for decreased BMD [p = 0.001, odds ratio (95% CI) = 4.36 (1.79–10.64)].

On LS T scores multivariate analysis, age [p = 0.001, odds ratio (95% CI) = 1.08 (1.03–1.14) for each one year increase in age] and low body mass index [p = 0.027, odds ratio (95% CI) = 1.23 (1.01–1.25) for each one kg/m2 decrease in BMI] were significantly associated with having decreased BMD (osteopenia or osteoporosis). Sex, smoking, disease location, small bowel surgery and steroid use were not associated with low BMD.

Conclusions: Low BMD was associated with CD, particularly in older and low body mass index patients. The finding that steroid use was not associated with low BMD can be explained by the short duration disease of our population (most of our patients were diagnosed in the age of biologics and were submitted to one or two short steroid treatment).