Health care for osteoporosis in inflammatory bowel disease: unmet needs in care of male patients?
BACKGROUND AND AIMS
Osteoporosis is a frequent complication of inflammatory bowel disease (IBD). It may be related to IBD itself or to its therapy. In this study, the quality of care regarding diagnosis and treatment of osteoporosis was examined.


METHODS
In this retrospective, monocentric study 293 consecutive patients with IBD (98 ulcerative colitis, 195 Crohn's disease) were included. Information on age, gender, weight, nicotine abuse, course, disease pattern and medication was assessed, results of dual X-ray absorptiometry (DEXA-scan) were evaluated.


RESULTS
DEXA-scan was performed in 174 patients (59 male, 115 female). Bone mineral density (BMD) was impaired in 38.5% of these patients. Male patients were diagnosed more often with osteopenia or osteoporosis than females (55.9% vs. 29.6%, p=0.03) and had a risk of bone disease comparable to postmenopausal women. Additionally, duration of corticosteroid treatment and IBD were identified as risk factors for osteoporosis. Follow up DEXA-scan demonstrated an overall deterioration of BMD in patients with normal baseline results.


CONCLUSIONS
While in general, women are considered at higher risk for osteoporosis, male patients had a higher risk of impaired BMD, especially when under treatment with corticosteroids. The high incidence of reduced BMD supports the recommendation to screen patients with IBD at an early stage of disease, although a possible bias has to be considered for patients at a tertial referral centre for IBD. Patients with normal baseline DEXA-scan were still at risk to develop bone disease and it seems advisable to monitor patients with IBD for reduced BMD continually.
['Walldorf|Jens|J|', 'Krummenerl|Annette|A|', 'Engler|Kristin|K|', 'Busch|Juliane|J|', 'Dollinger|Matthias M|MM|', 'Seufferlein|Thomas|T|', 'Albert|Jörg G|JG|']
D015502:Absorptiometry, Photon D000328:Adult D000367:Age Factors D015519:Bone Density D001851:Bone Diseases, Metabolic D015331:Cohort Studies D003093:Colitis, Ulcerative D015897:Comorbidity D003424:Crohn Disease D003695:Delivery of Health Care D005260:Female D005858:Germany D006801:Humans D015994:Incidence D015212:Inflammatory Bowel Diseases D008297:Male D008875:Middle Aged D020380:Needs Assessment D010024:Osteoporosis D011379:Prognosis D012189:Retrospective Studies D018570:Risk Assessment D012737:Sex Factors
Osteoporosis Inflammatory bowel disease Crohn's disease Colitis ulcerosa