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P788 Risks and predictors of osteoporosis in inflammatory bowel diseases: a nationwide Korean population-based cohort study

T. J. Kim*1, S. M. Kong1, J. B. Shin1, E. R. Kim1, S. N. Hong1, D. K. Chang1, Y-H. Kim1

1Samsung Medical Center, Seoul, South Korea

Background

Risk of osteoporosis and pathologic fracture in patients with inflammatory bowel disease is higher than general population. Guidelines recommend screening for osteoporosis in IBD patient with conventional risk factors. However, little is known about the incidence and predictors of osteoporosis in IBD in Asian population. We estimated the incidence and risk factors of osteoporosis and pathological fracture in patients with inflammatory bowel disease.

Methods

Using the Korean National Health Insurance Research Database, we included 29,978 IBD patients and 185,566 age- and sex-matched controls. Cohort enrolled from January 2012 until December 2013 and followed up until December 2016. We calculated the hazard ratios (HRs) and 95% confidence intervals (CIs) of osteoporosis and pathological fracture in both cohorts by using Cox regression models.

Results

After adjusted with age, sex, comorbidity, the overall osteoporosis is higher in patients with inflammatory bowel disease [adjusted hazard ratio (aHR), 1.42; 95% CI, 1.36–1.49, p < 0.001]. Further analysis indicated that male (aHR, 1.92; 95% CI, 1.75–2.11, p < 0.001), young-aged patients (aHR, 5.13; 95% CI, 4.39–5.99, p < 0.001), patients with Crohn’s disease (aHR, 2.01; 95% CI, 1.84–2.21, p < 0.001) and patients without comorbidities (aHR, 1.69; 95% CI, 1.57–1.81, p < 0.001) exhibited excessive risks of osteoporosis.

Incident casesPYIncidence rate (/1000)Crude HR (95% CI)p-valueAdjusted HR (95% CI)p-value
Non-IBD9074542814.0416.721
IBD202786793.4623.351.40 (1.33–1.47) < .00011.42 (1.36–1.49) < .0001
UC153659938.2525.631.53 (1.45–1.62) < .00011.30 (1.23–1.37) < .0001
CD48826751.4318.241.09 (0.99-1.20)0.06042.01 (1.84–2.21) < .0001

Incidence and adjusted hazard ratio of osteoporosis IBD patients with ulcerative colitis and Crohn’s disease compared with controls.

Conclusion

The incidence of osteoporosis and related fracture in patients with IBD was higher than that of non-IBD population. Understanding the increased risk of osteoporosis facilitates early diagnosis and may contribute to improvement in the quality of care of patients with IBD.