Risk of Low Bone Mineral Density Higher in Inflammatory Bowel Disease

Newswise — 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 from the University of Virginia (UVA) Health System released today at the 68th Annual Scientific Meeting of the American College of Gastroenterology. In a study of 163 patients of whom 14 percent were African Americans, researchers also found that African American race had a positive correlation with lower bone mineral density.

"Most epidemiology studies of bone mineral density in IBD are from centers with racially homogeneous patient populations," said Lawrence W. Comerford, M.D., one of the UVA investigators. "In this study we wanted to determine the risk factors for low BMD in a large, racially heterogeneous cohort of IBD patients." Patients in the study were screened for bone mineral density using a dual energy X-ray absorptiometry (DEXA) scan. The researchers grouped the patients according to types of IBD and found that among those in the study with Crohn's disease, osteopenia (reduced bone density) was found in 48% at the hip and 33% in the spine, while osteoporosis (bone loss) was found in 6% at the hip and 11% at the spine. Among subjects with ulcerative colitis, osteopenia 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.

Positive risk factors for low BMD at the hip included age, low body mass index, and African American race. The risk for low BMD in the spine increased with low body mass index,

African American race and disease severity. Also, the researchers found that gender, type of IBD, disease duration and family history of osteoporosis did not correlate with low BMD.

Guidelines Help Physicians Identify High-Risk PatientsIn 2002 the American college of Gastroenterology published a scientific monograph, "Osteoporosis & Inflammatory Bowel Disease: A Guide to Diagnosis & Management for the Gastroenterologist." In this monograph, an expert panel made recommendations about various methods of diagnosis, including the appropriate use of DEXA scans. Researcher Sunanda V. Kane, M.D., FACG of the University of Chicago wanted to assess the impact of these recommendations on the clinical practice of gastroenterologists.

In a survey of 140 community-based and 60 university-based gastroenterologists, Dr. Kane's research revealed that only 30 percent of gastroenterologists were aware of the prevalence of osteopenia/osteoporosis in IBD, only 10 percent ordered DEXA scans on a regular basis, and only 12 percent felt that osteoporosis should be treated by a gastroenterologist. In the 3-month period after the ACG recommendations were promulgated, Dr. Kane found a 40 percent increase in DEXA scans ordered by community gastroenterologists.

The ACG was formed in 1932 to advance the scientific study and medical treatment of disorders of the gastrointestinal (GI) tract. The College promotes the highest standards in medical education and is guided by its commitment to meeting the needs of clinical gastroenterology practitioners. Consumers can get more information on GI diseases through the following ACG-sponsored programs:· 1-800-978-7666 (free brochures on common GI disorders, including ulcer, colon cancer, gallstones, and liver disease)· 1-800-HRT-BURN (free brochure and video on heartburn and GERD)· http://www.acg.gi.org (ACG's Web site)