Vitamin D Deficiency and Corticosteroid Use Are Risk Factors for Low Bone Mineral Density in Inflammatory Bowel Disease Patients
Vitamin D Deficiency and Corticosteroid Use Are Risk Factors for Low Bone Mineral Density in Inflammatory Bowel Disease Patients
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DOI：
10.1007/s10620-014-3102-x
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发表时间：
2014-08-01
影响因子：
3.1
通讯作者：
Malaty, Hoda M.
中科院分区：
文献类型：
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作者：
Abraham, Bincy P.;Prasad, Preethi;Malaty, Hoda M.
由于有几个因素可以导致低骨密度（BMD），我们调查了维生素D在低BMD中的作用，同时控制炎症性肠病（IBD）患者的其他危险因素。我们在2008年至2012年期间对成人IBD患者进行了前瞻性横断面研究。记录包括年龄、性别、种族、体重指数（BMI）、沿着疾病类型和部位、维生素D水平、既往皮质类固醇使用情况和抗肿瘤坏死因子（TNF）使用情况等人口统计学数据，并与DEXA结果进行评价。40%的患者存在低BMD，CD患者的发生率是UC患者的两倍（p = 0.048）。男性（p = 0.05）、亚洲种族（p = 0.02）和皮质类固醇使用史（p = 0.001）与低BMD患病率较高相关。年龄、体重指数或疾病部位不增加低BMD的风险。低维生素D的总体患病率为60%，37%的患者发现维生素D不足（25-羟基水平在20和30 ng/mL之间），23%的患者发现维生素D缺乏（水平< 20 ng/mL）。维生素D不足和缺乏的患者有可能有低BMD的两倍（p = 0.049）和近3倍（p = 0.02），分别低维生素D，男性，亚洲种族，CD，皮质类固醇的使用显着增加的风险有低BMD，而年龄和疾病部位不影响我们的IBD人群的BMD。评估维生素D营养缺乏和限制皮质类固醇的使用仍然很重要，以帮助预防IBD患者的低BMD。
As several factors can contribute to low bone mineral density (BMD), we investigated the role of vitamin D in low BMD while controlling for other risk factors in inflammatory bowel diseases (IBD) patients.We conducted a prospective cross-sectional study between 2008 and 2012 in adult IBD patients. Demographic data including age, gender, ethnicity, BMI, along with disease type and location, vitamin D levels, prior corticosteroid use, and anti-TNF use were recorded and evaluated with DEXA results.A total of 166 patients [105 Crohn's disease (CD), 61 ulcerative colitis (UC)] qualified for the study. Low BMD was found in 40 %, twice as frequently in CD than in UC (p = 0.048). Higher prevalence of low BMD was associated with those of male gender (p = 0.05), Asian ethnicity (p = 0.02), and history of corticosteroid use (p = 0.001). Age, body mass index, or disease location did not increase the risk of low BMD. The overall prevalence of low vitamin D was 60 %, with insufficiency (25-hydroxy levels between 20 and 30 ng/mL) found in 37 % and deficiency (levels < 20 ng/mL) found in 23 % of the patients. Vitamin D insufficient and deficient patients were two times (p = 0.049) and almost 3 times (p = 0.02) as likely to have low BMD, respectively.Low vitamin D, male gender, Asian ethnicity, CD, and corticosteroid use significantly increased the risk of having low BMD, while age and disease location did not affect BMD in our IBD population. It remains important to evaluate for vitamin D nutritional deficiency and limit corticosteroid use to help prevent low BMD in IBD patients.