P522 Factors reducing bone mineral density in patients with inflammatory bowel disease
D. Abdulganieva*1, E. Bodryagina1, A. Odintsova2
1Kazan State Medical University, Department of Hospital Therapy, Kazan, Russian Federation, 2Republican Clinical Hospital, Department of Gastroenterology, Kazan, Russian Federation
One of the extraintestinal manifestations of inflammatory bowel disease (IBD) is a reduction in bone mineral density (BMD) - osteoporosis and osteopenia. It is known that the basis of reduction of BMD in patients with ulcerative colitis (UC) and Crohn's disease (CD) are clinical features of IBD, malabsorption of vitamins, as well as long-term use of drugs, in particular corticosteroids. The aim of our study was to identify the factors reducing the level of BMD in patients with IBD.
159 patients with IBD were included into the study, UC was 92 (57,9%) patients, CD - 67 (42,1%) patients. The average age of patients was 36,4 ± 4,1 years, in patients with UC - 32,6 ± 2,8 years, CD - 37,2 ± 3,1 years. By gender, men patients with IBD were 72 (45,3%), women - 87 (54,7%) patients.
BMD was measured by using minidozed digital X-ray diagnostic instrument "Diascan". Interpretation of the results was performed using T-test. Normal bone density was determined at the level of T-kriteriya ≥ -1, osteopenia - in the range of -2.5 <T-score <-1, osteoporosis was defined as T-kriteriya ≤ -2,5.
Normal BMD observed in 33 (20.8%) of patients with IBD, UC - 17 (51.6%), CD - 16 (48.9%). Decrease in BMD was detected in 126 (79.2%) patients, of whom 62 (49%) - osteopenia, 64 (51%) - osteoporosis.
Assessment of depending level of BMD and patient gender showed that women slightly more common normal BMD and osteopenia (61%), and men - osteoporosis (55%).
Analysis of the effect of treatment on the reduction of BMD in IBD patients showed that patients treated with steroids for over a year, had a significant decrease in BMD compared to patients at least a year of therapy (60% vs 35%, OR 2.8). The dose steroids also had a decrease in BMD value: patients receiving prednisone at a dose of 30 mg, also had a significant decrease in BMD compared to patients treatment with prednisone at least 30 mg (54% vs 27%, OR 3.2).
Decrease in BMD was observed in the vast amount (79%) of patients with IBD. Was found a higher prevalence of osteoporosis among men (55%). Duration of use of steroids and their high dosage over an extended time significantly affects the level of BMD patients (p<0,05).