Inflammatory bowel disease may be associated with increased risk of osteoporosis and osteopeia

1. In postmenopausal patients with ulcerative colitis (UC) or Crohn’s disease (CD), approximately one-third had osteoporosis while approximately 40% had osteopenia.

2. In men aged over 50 years with UC or CD, approximately 13% had osteoporosis while approximately 50% had osteopenia. 

Evidence Rating Level: 2 (Good)

Osteopenia and osteoporosis are diseases that are well-known to occur commonly in those with inflammatory bowel disease (IBD). However, the prevalence of osteopenia and osteoporosis at IBD diagnosis has not been well characterized, and bone mineral density (BMD) testing remains underutilized in these patients. This prospective cohort study therefore sought to determine the incidence of osteopenia and osteoporosis at IBD diagnosis. 209 and 141 patients with a new diagnosis of UC (median[IQR] age, 44[28-57]; 53.1% female) and CD (median age[IQR], 36[25-54]; 46.1% female) from Copenhagen were included and assessed for osteopenia and osteoporosis via BMD testing using dual-energy X-ray absorptiometry (DEXA). Among postmenopausal women with a new diagnosis of UC and CD, 35.7% (15/42) and 28.6% (6/21) were diagnosed with osteoporosis respectively. Among males aged above 50 years with a new diagnosis of UC and CD, 13.2% (5/38) and 12.5% (3/24) were diagnosed with osteoporosis respectively. The incidence of osteopenia in postmenopausal women with newly diagnosed UC and CD was 40.5% (17/4) and 38.1% (8/21) respectively, while in men aged above 50 with newly diagnosed UC and CD it was 44.7% (17/38) and 50.0% (12/24) respectively. Overall, this study showed that postmenopausal women and men aged over 50 with a new diagnosis of UC and CD experience much higher rates of osteopenia and osteoporosis compared to those without UC and CD. 

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