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P283. Celiac and Crohn's disease as risk factors for secondary osteoporosis

N. Azzopardi1, P. Ellul1, 1Mater dei Hospital, Gastroenterology, Msida, Malta

Background

Crohn's and celiac disease are associated with an increased risk of osteoporosis.

Methods

Celiac and Crohn's disease patients attending gastroenterology out-patients were referred for a DEXA scan and their bone density and Frax score results were analysed.

Results

73 celiac (17 male) and 83 Crohn's disease (41 male) patients were analysed.

Mean age at diagnosis among celiac patients: 41.4 years; mean disease duration: 7.95 years. Mean T score (hip): −1.34, mean T score (spine): −1.58, mean Z score (hip): −0.49, mean Z score (spine): −0.81. Frax Score: mean 10-year risk of major fracture: 6.78% (range: 2–25%); mean 10-year risk of hip fracture: 1.98% (range: 0–11%). 15 patients were on bisphosphonates while 28 individuals were on calcium supplements. 12 patients had thyroid pathologies. There was no difference between the T scores (hip) of patients having normal tissue transglutaminase IgA levels and those having high levels (Student t test p: 0.75). There was also no difference in the T scores (hip) according to gender (Student t test p: 0.75) or disease duration (ANOVA p: 0.68). However, there was a statistically significant difference in the T scores (hip) according to body mass index, with increasing T scores being associated with increasing BMIs (ANOVA p: 0.013). There was no decrease in the T scores of celiac patients with thyroid pathologies when compared with those without (Student t test p: 0.41).

Mean age at diagnosis among Crohn's patients: 30 years; mean disease duration: 9 years. Mean T score (hip): −1.3, mean T score (spine): −0.7, mean Z score (hip): −0.7 and mean Z score (spine): −0.4. Mean 10-year risk of major fracture: 7.09% (range: 2.5–53%); mean 10-year risk of hip fracture: 2.89% (range: 0.1–39%).

There was no statistical difference between the T scores (hip) of celiac and Crohn's disease patients (Student t test p: 0.75) and between the Frax scores for major (p: 0.70) and hip fractures (p: 0.35) of celiac and Crohn's disease patients. However there was a significant difference between the T scores (spine) of celiac and Crohn's disease patients (Student t test p: <0.0001) with lower T scores among celiac patients.

Conclusion

While both celiac and Crohn's disease give an increased risk of osteoporosis, there is a significant difference in the T score (spine) between the two groups though such difference is not present in the hip.