الفهرس 
Inflammatory Bowel DiseaseOnly 14 pages are availabe for public view
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Abstract
Inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn’s disease (CD), is associated with low bone mineral density (BMD). The prevalence of osteopenia and osteoporosis in IBD patients ranges from 22–77 and 17–41%, respectively, depending on the study population, study design, and disease location (Ferreira et al., 2019).
Reduction in BMD is associated with an increased risk of fractures. IBD patients can have up to 40% more fractures than the general population, which contributes to increased morbidity and reduced quality of life (Ludvigsson et al., 2019).
We aimed in this study to evaluate risk and correlation assessment of bone mineral density (BMD) changes in inflammatory bowel disease patients.
❖ Subjects and methods
A cross-sectional study was conducted at the Gastroenterology Unit and Internal Medicine Department, Faculty of Medicine, Menoufia University.
The study was conducted on forty (40) patients diagnosed with IBD and a control group consisted of twenty (20) apparent healthy subjects matched according to the age and gender of IBD patients.
The diagnosis of IBD (including Crohn’s disease and ulcerative colitis) was based on standard criteria including clinical criteria, endoscopy radiological and histological data, and the Montreal classification was used for disease severity.
❖ Results
Forty patients were studied, 24 patients with UC, and 16 with CD. Age ranged from 29 to 37 years, mean of 32.8±2.65 (SD) years. Most patients were female 23/40(57.5%). The control group consisted of 20 healthy
Summary
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subjects. There were statistically insignificant differences in age and gender between our study groups (P<0.05 for all) which denotes good matching.
Patients in the CD patients’ group were diagnosed at the mean age of 27.75±3.68 years while at the mean age of 31.58±1.86 years at UC patients with a statistically significant difference (p<0.001). In the CD group, 11 had active disease, and 7 in the UC group with statistically significant differences (p-=0.014). Most CD patients had not undergone surgery on 9/16(56.25%) and 21/24 (87.5%) in the UC group. In the CD group, for those operating on (4/16), partial colon resection was the most frequent surgery (25%), followed by the small intestine and colonic resection (18.75%). In the UC group, for those operating on (2/24), partial colon resection was the most frequent surgery (8.3%), followed by small intestine resection (4.2%). Corticosteroid use, dose, and duration showed insignificant differences between groups (p>0.05).
Among the CD group, Ileocolonic disease (L3 of the Montreal classification) was present in (56%) of patients, (25%) at L2- colonic, (13%) at L1-ileal, and 6% L4-upper GIT. Also, (69%) of patients had the non-stricturing non-penetrating disease (B1 of the Montreal classification). The perianal disease was present in (25%) of patients.
Among the ulcerative colitis group, Most of the UC group had extensive UC followed by left-sided UC.
There is no significant difference between both groups in the prevalence of osteoporosis (p=0.360). Also, the UC group had a significantly higher percentage of patients with abnormal BMD (62.5%) (p<0.001).
Bone mineral density had significant indirect correlations with disease activity and age of disease onset (rho=-0.356, p=0.005 and rho=-0.524, p<0.001, respectively.