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P198. Prevalence of bone demineralization in patients with inflammatory bowel disease

C.C. Prelipcean1, C. Mihai1, M. Dranga1, G. Dumitrescu1, B. Mihai2

1University of Medicine and Pharmacy “Gr. T. Popa”, Gastroenterology, Iasi, Romania; 2University of Medicine and Pharmacy “Gr. T. Popa”, Diabetes, Nutrition and Metabolic Diseases, Iasi, Romania

Background: The impact on articular and skeletal structures in progressive inflammatory bowel disease (IBD) is well known. The physiopathology and mechanisms of changes of bone mineral density are secondary to bone inflammatory involvement and to reduction in bone mass.

Aims: Our aims were to screen for osteopenia and osteoporosis patients with IBD and to evaluate the risk factors associated with the progression of low bone mineral density in IBD.

Methods: A prospective study was undertaken over a period of 2 years (2008–2010) at the Institute of Gastroenterology and Hepatology Iasi, Romania on patients diagnosed with IBD (clinical, endoscopic and histological). The study recorded patients' age, sex, smoking habits, alcohol consumption, previous bowel resection, body mass index (BMI), disease evolution with number of acute flares, the extension and the treatment of IBD. Exclusion criteria included patients with abnormal thyroid and parathyroid tests, diabetes mellitus, cancer, renal and liver failure. The assessment of bone density was performed using dual energy X ray absorptiometry (DEXA) in the lumbar spinal column (L2-L4) or in the proximal femur. The results were recorded as T score.

Results: The study included 80 patients age ranged from 23 to 55 years, 31 female (38.75%) and 49 male (61.25%). 56 suffered from ulcerative colitis, 23 from Crohn's disease, and 1 had indeterminate colitis. 49 patients (61.25%) had normal BMD values and 31 patients (38.75%) had reduction in bone mass of whom 4 had osteoporosis. The remaining 27 patients had osteopenia (11 with UC and 16 with CD). The most important risk factors for BMD changes (but without statistical significance) were Crohn disease, age, smoking and corticoid therapy, especially in patients on long evolution of IBD. We didn't find any correlation with sex, alcohol abuse, BMI, the activity and extension of IBD.

Conclusions: The prevalence of osteopenia and osteoporosis is relative high in patients with IBD. We can not establish a statistic significant relationship between risk factors and prevalence of bone mineral disturbances in IBD patients.