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P556 The prevalence of metabolic bone disease in patients with IBD- preliminary results from POLIBD study

J. Sztembis1, D. Piątek2, S. Jarmakiewicz3, P. R. Kiela4, R. Filip*5,6

1Clinical Hospital No. 2, Department of Internal Medicine and Endocrinology, Rzeszow, Poland, 2Medical University of Lublin, Chair and Departament of Conservative Dentistry with Endodontics, Lublin, Poland, 3University of Rzeszów, Poland, Faculty of Medicine, Rzeszów, Poland, 4Steele Children's Research Center, Departament of Pediatrics and Immunology, Tucson, USA, 5Clinical Hospital No. 2 Rzeszow, Departament of Gastroenterology with IBD Unit, Rzeszów, Poland, 6University of Rzeszów, Faculty of Medicine, Rzeszów, Poland

Background

The most common bone metabolic diseases in IBD patients are osteopenia and osteoporosis. The more rare ones are osteomalacia and avascular necrosis. There are many mechanisms underlying the poor metabolic state of the bones in these patients. The occurrence of osteopenia and osteoporosis in this group of patients differs depending on the study population with values ranging in case of osteopenia from 22 to 77 per cent and osteoporosis from 17 to 41%. Authors decided to analize the occurance of osteoporosis and osteopenia in patients hospitalised in our Clinic from 2016 to 2018.

Methods

We measured bone mineral density (BMD) of patients with IBD with dual- energy-X-ray-absorptiometry (DEXA scans). We divided the patients into 2 groups: the first one with ulcerative colitis (UC -29 patients, 19 women, 10 men) and the second one with Crohn’s disease (CD - 55 patients, 30 women, 25 men). Both groups were subdivided depending on age - under 30 years old (we measured T-score for this group) and over 30 years old. (We measured Z- score for this group.)

Results

In the group of UC patients the mean T-score for 11 patients under 30 years old was 0.7363, −0.856 for women, −0.2 for men. Osteopenia occurred in four young women and no ostepenia was diagnosed among men. There was no osteoporosis in UC patients under 30. In the group of UC patients over 30 years old (18 patients, 10 women, 8 men) the mean Z-score was −1.07, −0.48 for women, −1.825 for men. Osteopenia was observed in 2 women and 5 men, osteoporosis in 4 men. In the group of CD patients the mean T-score for 28 patients under 30 years old was 0.844, −0.65 for women, −1.087 for men. Osteopenia occurred in 8 young women and 2 young men. There was one case of osteoporosis in CD patients under 30. In the group of CD patients over 30 years old (27 patients, 15 women, 12 men) the mean Z-score was −0.641, −0.73 for women, −0.514 for men. Osteopenia was observed in 2 women and 8 men. There was no osteoporosis in this group of patients.

Conclusion

The highest prevalence of osteopenia in young group of patients was observed in 4!4% women with UC, and in 53% women with CD. No osteoporosis was observed there.

In the older group of patients with IBD (over 30 years old) the highest risk of metabolic bone diseases - both osteopenia and osteoporosis - was in men's group with UC - 62.5% had osteopenia and 25% had osteporosis. Men over 30 years old with UC are at the highest risk of developing metabolic bone diseases in the IBD patients.