Background and aims: Low bone mineral density (BMD) is a common complication in patients with inflammatory bowel disease (IBD). However, debates are ongoing with regard to the other involved factors, especially in younger patients. This study aimed to evaluate the parameters that contribute to decreased BMD, focusing on premenopausal women and men aged <50 years.
Methods: This study has evaluated 81 patients with IBD and 81 age-, sex- and body mass index (BMI)-matched controls. Blood tests were conducted on IBD patients, and dual-energy X-ray absorptiometry (DXA) scan was performed on both groups.
Results: Low BMD and fragility fracture were found to be more prevalent in IBD patients than in healthy subjects (49.3% vs 23.4%, p = 0.001 and 9.8% vs 1.2%, p = 0.01, respectively). Patients with low BMD were older, with a longer disease duration, higher faecal calprotectin (FC) level and lower magnesium and lean mass (appreciated as appendicular skeletal muscle index (ASMI)). Multiple regression analysis revealed that ASMI, age and use of glucocorticoids were independent parameters for decreased BMD. Although 91.3% of the patients had a 25-hydroxy vitamin D level of <30 ng/mL, it was not a statistically significant factor for decreased BMD.
Conclusion: In our study, the levels of vitamin D did not seem to have an important impact on BMD. Conversely, FC, magnesium and lean mass are important factors, suggesting that good control of disease, adequate magnesium intake and increased lean mass can have a good impact on bone metabolism in patients with IBD.
Plasma Choline, Nicotine Exposure, and Risk of Low Bone Mineral Density and Hip Fracture: The Hordaland Health Study