Risk factors for osteoporosis in inflammatory bowel disease patients

作     者：Carla Andrade Lima Andre Castro Lyra Raquel Rocha Genoile Oliveira Santana 

作者机构：Pos-graduation program in medicine and healthFederal University of Bahia Department of Gastroenterology Federal University of Bahia Department of Sciences of NutritionSchool of NutritionFederal University of Bahia 

出 版 物：《World Journal of Gastrointestinal Pathophysiology》 (世界胃肠病理生理学杂志（英文版）（电子版）)

年 卷 期：2015年第6卷第4期

页      面：210-218页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Bone mineral density Crohn’s disease Osteoporosis 

摘      要：Inflammatory bowel disease(IBD) patients exhibit higher risk for bone loss than the general population. The chronic inflammation causes a reduction in bone mineral density(BMD), which leads to osteopenia and osteoporosis. This article reviewed each risk factor for osteoporosis in IBD patients. Inflammation is one of the factors that contribute to osteoporosis in IBD patients, and the main system that is involved in bone loss is likely RANK/RANKL/osteoprotegerin. Smoking is a risk factor for bone loss and fractures, and many mechanisms have been proposed to explain this loss. Body composition also interferes in bone metabolism and increasing muscle mass may positively affect BMD. IBD patients frequently use corticosteroids, which stimulates osteoclastogenesis. IBD patients are also associated with vitamin D deficiency, which contributes to bone loss. However, infliximab therapy is associated with improvements in bone metabolism, but it is not clear whether the effects are because of inflammation improvement or infliximab use. Ulcerative colitis patients with proctocolectomy and ileal pouches and Crohn s disease patients with ostomy are also at risk for bone loss, and these patients should be closely monitored.