Health care for osteoporosis in inflammatory bowel disease: unmet needs in care of male patients?

J Crohns Colitis. 2013 Dec;7(11):901-7. doi: 10.1016/j.crohns.2012.12.008. Epub 2013 Jan 18.


Background and aims: Osteoporosis is a frequent complication of inflammatory bowel disease (IBD). It may be related to IBD itself or to its therapy. In this study, the quality of care regarding diagnosis and treatment of osteoporosis was examined.

Methods: In this retrospective, monocentric study 293 consecutive patients with IBD (98 ulcerative colitis, 195 Crohn's disease) were included. Information on age, gender, weight, nicotine abuse, course, disease pattern and medication was assessed, results of dual X-ray absorptiometry (DEXA-scan) were evaluated.

Results: DEXA-scan was performed in 174 patients (59 male, 115 female). Bone mineral density (BMD) was impaired in 38.5% of these patients. Male patients were diagnosed more often with osteopenia or osteoporosis than females (55.9% vs. 29.6%, p=0.03) and had a risk of bone disease comparable to postmenopausal women. Additionally, duration of corticosteroid treatment and IBD were identified as risk factors for osteoporosis. Follow up DEXA-scan demonstrated an overall deterioration of BMD in patients with normal baseline results.

Conclusions: While in general, women are considered at higher risk for osteoporosis, male patients had a higher risk of impaired BMD, especially when under treatment with corticosteroids. The high incidence of reduced BMD supports the recommendation to screen patients with IBD at an early stage of disease, although a possible bias has to be considered for patients at a tertial referral centre for IBD. Patients with normal baseline DEXA-scan were still at risk to develop bone disease and it seems advisable to monitor patients with IBD for reduced BMD continually.

Keywords: Colitis ulcerosa; Crohn's disease; Inflammatory bowel disease; Osteoporosis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Age Factors
  • Bone Density
  • Bone Diseases, Metabolic / diagnosis
  • Bone Diseases, Metabolic / epidemiology
  • Bone Diseases, Metabolic / therapy*
  • Cohort Studies
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / epidemiology
  • Colitis, Ulcerative / therapy
  • Comorbidity
  • Crohn Disease / diagnosis
  • Crohn Disease / epidemiology
  • Crohn Disease / therapy
  • Delivery of Health Care / standards*
  • Delivery of Health Care / trends
  • Female
  • Germany
  • Humans
  • Incidence
  • Inflammatory Bowel Diseases / diagnosis*
  • Inflammatory Bowel Diseases / epidemiology
  • Inflammatory Bowel Diseases / therapy
  • Male
  • Middle Aged
  • Needs Assessment
  • Osteoporosis / diagnosis
  • Osteoporosis / epidemiology
  • Osteoporosis / therapy*
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Sex Factors