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      Risk of Low Bone Mineral Density Higher in Inflammatory Bowel Disease: Presented at ACG

      By Maggie Schwarz

      BALTIMORE, MD -- October 21, 2003 -- The risk of low bone mineral density (BMD) in patients with inflammatory bowel disease (IBD) increases with age, lower body mass index and severity of disease, according to a new study reported here at the 68th Annual Scientific Meeting of the American College of Gastroenterology.

      Lawrence W. Comerford, MD, MS, Assistant Professor of Internal Medicine, Department of Internal Medicine Division of Gastroenterology and Hepatology, University of Virginia Health System, Charlottesville, United States, and coinvestigators, studied 163 patients, of whom 14% were African American, to determine whether IBD patients are at higher risk of low BMD.

      Patients with IBD have been reported to be at increased risk of low BMD, but most studies of bone mineral density in IBD are from centres with racially homogeneous patient populations. The University of Virginia group wanted to determine risk factors for low BMD in a large, racially heterogeneous cohort of IBD patients.

      Patients recruited from the University of Virginia health system completed a 30-item medical-history questionnaire, and their medical records were reviewed for possible risk factors of low BMD. Risk factors reviewed included age, sex, race, body mass index, steroid use, duration and severity of IBD, type of IBD (Crohn's disease or ulcerative colitis), disease location, surgical resections and family history of osteoporosis.

      One hundred twenty-six patients were screened for BMD using a dual energy x-ray absorptiometry (DEXA) scan of the hip and lumbar spine. Researchers grouped patients according to type of IBD and found that among those with Crohn's disease, osteopenia was found in 48% at the hip and 33% in the spine, while osteoporosis was found in 6% at the hip and 11% at the spine. Among subjects with ulcerative colitis, osteopoenia was found in 29% at the hip and 25% at the spine, with osteoporosis found in 8% at the hip and 13% at the spine. The African-American subjects had a positive correlation with lower bone mineral density.

      Positive risk factors for low BMD at the hip included age, low body mass index and African American race. Risk for low BMD in the spine increased with low body mass index, African American race and disease severity. Gender, type of IBD, disease duration and family history of osteoporosis did not correlate with low BMD.

      A significant proportion of the present cohort of IBD patients living in the southeastern United States, the authors concluded, have low BMD.


      [Study Title: Low Bone Mineral Density in Inflammatory Bowel Disease – A Study of the Prevalence and Risk Factors. Abstract 283]



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