, Volume 91, Issue 5, pp 356-363
Date: 16 Sep 2012

Longitudinal Change in Bone Mineral Density in a Population-Based Cohort of Patients with Inflammatory Bowel Disease

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Abstract

Persons with inflammatory bowel disease (IBD) are reported to have a high prevalence of osteoporosis and reduced bone mineral density (BMD) and to be at higher risk of fracture. The course of BMD loss over time is poorly characterized in persons with IBD. Eighty-six persons, stratified by age, were enrolled from a population-based longitudinal IBD cohort study to undergo BMD testing at baseline, with final BMD testing a mean of 4.3 years later. The proportion of subjects with significant change in BMD at the lumbar spine, total hip, and femoral neck was assessed, as were clinical, biochemical, and anthropomorphic changes. Vertebral radiographs were also obtained at baseline and at the end of follow-up in those aged 50 years and above to detect vertebral fractures. The change in BMD seen in this cohort of IBD patients was similar to the expected rate of BMD loss in the general population. Age >50 years, decreasing body mass index (BMI), and corticosteroid use were most notably correlated with BMD loss. Subjects aged <50 years did not have statistically significant declines in BMD. IBD symptom activity scores correlated poorly with BMD loss. Vertebral fractures were uncommon, with only two subjects out of 41 >50 years old developing a definite radiographic fracture over the course of follow-up. No major nonvertebral fractures were observed. Patients with IBD do not appear to have significantly accelerated BMD loss. Older age, decreasing BMI, and corticosteroid use may identify IBD patients at greater risk for BMD loss.

L Targownik has a consultant/advisory role to Pfizer Canada, Janssen Canada, Merck Canada, and Astra Zeneca Canada. W Leslie has a consultant/advisory role and has received funding from Amgen, Novartis, and Genzyme. C Bernstein has as a consultant/advisory role to Abbott Canada, Janssen Canada, Shire Canada and Vertex Pharmaceuticals and has received funding from Abbott Canada, Prometheus Laboratories, and Aptalis Pharmaceuticals. All other authors have stated that they have no conflict of interest.