Incidence, Risk Factors and Evaluation of Osteoporosis in Patients With Inflammatory Bowel Disease: A Danish Population-Based Inception Cohort With 10 Years of Follow-Up

2020 ◽  
Vol 14 (7) ◽  
pp. 904-914 ◽  
Author(s):  
Bobby Lo ◽  
Jakob Præst Holm ◽  
Marianne Kajbæk Vester-Andersen ◽  
Flemming Bendtsen ◽  
Ida Vind ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
At Risk ◽  
Bowel Disease ◽  
Population Based ◽  
Control Population ◽  
Inception Cohort ◽  
Mineral Density ◽  
Inflammatory Bowel

Abstract Background Patients with inflammatory bowel disease [IBD] including Crohn’s disease [CD] and ulcerative colitis [UC] are at risk of developing metabolic bone disease. The aims here were to investigate the screening strategy, incidence and risk factors of osteoporosis in a prospective population-based inception cohort. Method Between 2003 and 2004 all incident patients diagnosed with CD and UC in a well-defined Copenhagen area were included and followed until 2015. Data were compared with a control population [at a ratio of 1:20]. Regression models were performed with several covariates. The sensitivity of the Danish registries for osteoporosis was also assessed. Results A total of 513 patients were included [213 CD, 300 UC]. Overall, 338 (66%, CD: 164 [77%], UC: 174 [58%], p < 0.001] patients received ≥ 500 mg corticosteroid within a year, resulting in 781 patient-years at risk of osteoporosis. Of those, only 83 [10.6%] patient-years were followed by a dual-energy X-ray absorptiometry scan within the same or the following 2 years. Overall, 73 [14.2%] IBD patients (CD: 31 [14.6%], UC: 42 [14%]) and 680 [6.6%, p < 0.001] controls were diagnosed with osteoporosis during follow-up. The risk of osteoporosis was increased compared to the control population (odds ratio: CD: 2.9 [95% confidence interval: 2.0–4.1], UC: 2.8 [2.1–3.9]). Conclusion In this population-based inception cohort, the incidence of osteoporosis was significantly higher compared to a control population. Measurement of bone mineral density is infrequent, especially in patients at high risk of developing osteoporosis. These results demonstrate the need of further awareness of the risk of osteoporosis among IBD patients, and prospective population-based studies are warranted.

Direct and Indirect Costs of Inflammatory Bowel Disease: Ten Years of Follow-up in a Danish Population-based Inception Cohort

2019 ◽  
Vol 14 (1) ◽  
pp. 53-63 ◽  
Author(s):  
Bobby Lo ◽  
Ida Vind ◽  
Marianne Kajbaek Vester-Andersen ◽  
Flemming Bendtsen ◽  
Johan Burisch
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Indirect Costs ◽  
Population Based ◽  
Direct Costs ◽  
Control Population ◽  
Inception Cohort ◽  
Direct And Indirect Costs ◽  
Inflammatory Bowel

Abstract Background Inflammatory bowel disease [IBD], encompassing Crohn’s disease [CD] and ulcerative colitis [UC], places a high burden on health care resources. To date, no study has assessed the combined direct and indirect cost of IBD in a population-based setting. Our aim was to assess this in a population-based inception cohort with 10 years of follow-up. Methods All incident patients diagnosed with CD or UC, 2003–2004, in a well-defined area of Copenhagen, were followed prospectively until 2015. Direct and indirect costs were retrieved from Danish national registries. Data were compared with a control population [1:20]. Associations between the costs and multiple variables were assessed. Results A total of 513 (CD: 213 [42%], UC: 300 [58%]) IBD patients were included. No significant differences were found in indirect costs between CD, UC, and the control population. Costs for CD patients were significantly higher than those for UC regarding all direct expenditures (except for5-aminosalicylates [5-ASA] and diagnostic expenses). Biologics accounted for €1.6 and €0.3 million for CD and UC, respectively. The total costs amounted to €42.6 million. Only patients with extensive colitis had significantly higher direct costs (proctitis: €2273 [1341–4092], left-sided: €3606 [2354–5311], extensive: €4093 [2313–6057], p <0.001). No variables were significantly associated with increased total costs in CD or in UC patients. Conclusions In this prospective population-based cohort, direct costs for IBD remain high. However, indirect costs did not surpass the control population. Total costs were mainly driven by hospitalisation, but indirect costs accounted for a higher percentage overall, although these did decrease over time. Podcast This article has an associated podcast which can be accessed at https://academic.oup.com/ecco-jcc/pages/podcast

scholarly journals Erratum to “Cancer in inflammatory bowel disease 15years after diagnosis in a population-based European Collaborative follow-up study” [J Crohns Colitis (2011) 5, 430-442]

2012 ◽  
Vol 6 (1) ◽  
pp. 132-133 ◽  
Author(s):  
Konstantinos H. Katsanos ◽  
Athina Tatsioni ◽  
Natalia Pedersen ◽  
Mary Shuhaibar ◽  
Vicent Hernandez Ramirez ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Population Based ◽  
Follow Up Study ◽  
Inflammatory Bowel

Cost Analysis and Cost Determinants in a European Inflammatory Bowel Disease Inception Cohort With 10 Years of Follow-up Evaluation

2006 ◽  
Vol 131 (3) ◽  
pp. 719-728 ◽  
Author(s):  
Selwyn Odes ◽  
Hillel Vardi ◽  
Michael Friger ◽  
Frank Wolters ◽  
Maurice G. Russel ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Cost Analysis ◽  
Bowel Disease ◽  
Inception Cohort ◽  
Inflammatory Bowel

Risk Factors for Low Bone Density in Inflammatory Bowel Disease: Use of Glucocorticoids, Low Body Mass Index, and Smoking

2019 ◽  
Vol 37 (4) ◽  
pp. 284-290 ◽  
Author(s):  
Razi Even Dar ◽  
Yoav Mazor ◽  
Amir Karban ◽  
Sofia Ish-Shalom ◽  
Elena Segal
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Inflammatory Bowel Disease ◽  
Bone Density ◽  
Body Mass ◽  
Bowel Disease ◽  
Mineral Density ◽  
Low Bone Density ◽  
Low Body Mass Index ◽  
Inflammatory Bowel

Background: Inflammatory bowel disease (IBD) patients are reported to have lower bone density compared to healthy controls. There is limited consensus regarding factors affecting bone density among these patients. Our aim, therefore, was to determine clinical and genetic variables that contribute to lower bone mineral density (BMD) in IBD patients. Methods: A cross-sectional study of IBD patients treated in a tertiary referral center was performed. Epidemiological and clinical data were collected, and genetic testing for the common mutations in Nucleotide-binding Oligomerization Domain-containing protein (NOD)2 was performed. We examined correlations between the different variables and BMD in the total hip, femoral neck, and lumbar spine. Results: Eighty-nine patients (49% males, 67 Crohn’s disease [CD]) participated in the study. 42Forty-two (63%) of the CD and 13 (59%) of the ulcerative colitis patients met the criteria for osteoporosis/osteopenia. Factors associated with lower Z scores were low body mass index (BMI; r = –0.307, p = 0.005), use of glucocorticoids (likelihood ratio [LR] 5.1, p = 0.028), and a trend for male gender (LR = 3.4, p = 0.079). Among CD patients, low bone density showed borderline significance for association with gastrointestinal surgery (LR = 4.1, p = 0.07) and smoking (LR = 3.58, p = 0.06). Low levels of 25OHD were not associated with low BMD, nor were mutations in NOD2. No increased rate of fractures was seen among patients with osteopenia or osteoporosis. Conclusion: In addition to the generally accepted risk factors for osteoporosis (glucocorticoids, low BMI, smoking), male IBD patients had a trend toward lower BMD. Carrying a mutaticon in NOD2 did not confer a risk for bone loss.

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