Low Bone Mineral Density in Inflammatory Bowel Disease Patients

Abstract

Background and Aims: Inflammatory Bowel Disease (IBD) is associated with low bone mineral density (BMD). Several purported risk factors contribute to this risk, however there is still lack of consensus on criteria for screening in Australia. This study aims to assess screening and identify risk factors for low BMD in IBD patients at a single tertiary centre in the Asia-Pacific region

Methods: A retrospective review of IBD patients who attended an Australian tertiary centre between 2013 to 2018 was conducted. Risk factors for low BMD such as age, gender, BMI, type of IBD, smoking, steroid therapy, serum calcium and vitamin D levels were evaluated.

Results: A total of 236 of 544 (43%) IBD patients had a DEXA scan performed. Of those patients, 46.6% had low BMD on initial DEXA. Follow up DEXAs occurred in 33.1% of those 236 patients with an average time of 5 years between scans. Risk factors for low BMD were age ≥50 years (p≤0.001) and BMI <25 kg/m² (p<0.001). There were 21 of 236 (9%) patients who sustained a fracture in this study.

Conclusion: Screening rates for BMD in IBD patients was low at 43% at this single tertiary centre in the Asia-Pacific region. Approximately 47% has low BMD and age ≥50 years and BMI <25 kg/m² were identified as significant risk factors for low BMD. Early identification of those at risk of low BMD is important in order to prevent osteoporosis and related adverse skeletal events.