P593 Bone mineral density in a Spanish cohort of inflammatory bowel disease patients
J. Miranda-Bautista*1, M. D. Perez-Valderas1, A. Caballero-Marcos1, A. Diaz-Redondo2, I. Marin-Jimenez1, L. Menchen1
1Hospital General Universitario ‘Gregorio Marañón’, Gastroenterology Unit, Madrid, Spain, 2Hospital General Universitario, Preventive medicine and Epidemiology Service, Madrid, Spain
Bone metabolic disease (BMD) is a well-known complication of inflammatory bowel disease (IBD). The aim of this study is to analyse the prevalence of BMD in a large sample of Southern European patients with IBD, and secondarily identifying the clinical, metabolic, and pharmacological factors that are associated with osteoporosis in this population.
We have conducted an observational, retrospective and cross-sectional study of BMD based on the first bone densitometry (DEXA) in patients with IBD from our institution. Clinical charts have been systematically reviewed, and the data obtained have been included. BMD was defined as hip and/or spine T score < -1 standard deviation (SD). Osteoporosis was defined as hip and/or spine T score < -2.5 SD. DEXA results were evaluated taking into account the presence of possible factors involved in the development of osteoporosis in IBD patients.
From our IBD data base, 524 patients were included. Further, 43.9% of patients were male, and the mean age was 49.17 (SD 15.2) years. Crohn’s disease (CD) was diagnosed in 305 patients, ulcerative colitis (UC) in 204; and indeterminate colitis (IC) in 15 patients. Regarding IBD treatment; 411 patients received at least one tapered dosage of corticosteroids before DEXA, 214 were on immunomodulators, of which 192 (36.6%) on azathioprine, 16 (3.1%) on 6-mercaptopurine, and 5 (1%) on methotrexate. In addition, 108 patients were on biologic treatment: 83 (15.8%) on infliximab and 25 (4.8%) on adalimumab. BMD was diagnosed following above mentioned criteria in 334 (63.7%) of patients, while osteoporosis was diagnosed in 112 (21.3%) patients. Univariate analysis (T-test) comparing hip/spine T score with confound variables was performed. IMM therapy was found significantly associated with improvement of hip T score (p = 0.016), and UC (p = 0.007) and omeprazole treatment (p = 0.021) were associated with worsening in spine and hip T score, respectively. Multivariate analysis found age significantly related with BMD. Corticosteroid therapy almost reached signification. Age and UC diagnosis were associated with osteoporosis.
BMD is a frequent complication in IBD patients, especially in the elderly, under corticosteroid and omeprazole therapy. Special attention must be paid in early evaluation of bone density in these patients.