Ferda AKBAY HARMANDAR, Hasan CAN, AYHAN HİLMİ ÇEKİN, Seyit UYAR

Incidence of low bone mineral density and contributing factors in inflammatory bowel disease

Giriş ve Amaç: İnflamatuvar barsak hastalığı ülseratif kolit ve Crohn hastalığı adı altında temelde 2 formu kapsayan remisyon ve alevlen- melerle seyreden gastrointestinal sistemin kronik enfeksiyöz olmayan inflamatuvar hastalığıdır. İnflamatuvar barsak hastalarında kemik mine- ral yoğunluğunun azaldığı tespit edilmiştir. Bu azalmanın mekanizması tam anlaşılmamış olmakla birlikte multifaktöriyel olduğu belirtilmekte- dir. Çalışmamızın amacı inflamatuvar barsak hastalarında kemik mineral yoğunluğundaki azalmayı etkileyen faktörleri değerlendirilerek ülseratif kolit ve Crohn hastalığı'nı kemik mineral yoğunluğu açısından karşılaş- tırmaktır. Gereç ve Yöntem: Çalışmaya 18-70 yaş arası Antalya Eğitim ve Araştırma Hastanesi Dahiliye ve Gastroenteroloji kliniğinden takipli 102 ülseratif kolit ve 39 Crohn hastalığı dahil edildi. Hastaların kemik mineral yoğunluğu ölçümleri dual enerji x-ray absorbsiyometre yönte- miyle lomber vertebra ve femur boynunda yapıldı. Bulgular: Her iki hastalık grubunda lomber vertebra ve femur boynu T skorları benzerdi (lomber vertebra: Crohn hastalığı= -1,5±1,4; ülseratif kolit= -1,5±1,3; femur boynu: Crohn hastalığı= -1,1±1,1; ülseratif kolit = -0,9±1,0). Cro- hn hastalığı grubunda (n=39) %38 oranında osteoporoz, %35 oranında osteopeni tespit edildi. Ülseratif kolit grubunda (n=102) %21 oranında osteoporoz, %46 oranında osteopeni tespit edildi. Sonuç: Çalışmanın sonucunda inflamatuvar barsak hastalarında steroid kullanımı, vücut kitle indeksi, hastalık süresi, hastalık aktivitesi ve yaş ile kemik mine- ral yoğunluğunun ilişkili olduğunu belirledik. Ülseratif kolit grubunda SEO aktivite düzeyi >150 olan hastaların femur boynu Z/T skorları, SEO aktivite düzeyi

İnflamatuvar barsak hastalığında düşük kemik mineral dansitesi sıklığı ve etkileyen faktörler

Background and Aims: Inflammatory bowel disease is a chronic, non-infectious disease of gastrointestinal tract that chracterized by re- missions and exacerbations under the name of ulcerative colitis and Crohn's disease. Decreased bone mineral density is identified in inflam- matory bowel disease. The mechanism of this decrease is not exactly understood but it is reported as multifactorial. The aim of our study is to compare ulcerative colitis and Crohn's disease, in terms of bone min- eral density by evaluating the factors of the decrease in bone mineral density in inflammatory bowel disease. Materials and Methods: 102 ulcerative colitis and 39 Crohn's disease patients between the ages of 18 and 70 who are followed in Antalya Eğitim ve Araştırma Hastanesi Internal medicine and Gastroenterology clinical department included in the study. The patients bone mineral density in the lumber vertebrae and femoral neck regions were measured by dual energy x-ray absorp- tiometry method. Results: Spine and femur T scores were similar in the two groups (spine: Crohn's disease= -1,5±1,4; ulcerative colitis= -1,5±1,3; femur: Crohn's disease= -1,1±1,1; ulcerative colitis= -0,9±1,0). In Crohn's disease group, osteoporosis was present in %38 of the pa- tients and osteopenia was present in %35 of the patients. In ulcer- ative colitis group, osteoporosis was present in %21 of the patients and osteopenia was present in %46 of the patients. Conclusion: As a result of the study, we determine that there is an association between inflammatory bowel disease and the use of steroid, disease duration, disease activity, age and body mass index. A comparison of patients' disease activities and bone mineral density demonstrated significant- ly lower femur neck Z/T scores for patients with SEO activity levels >150 compared to those with SEO activity levels <150 in the ulcerative colitis group (p=0,005, p=0,020). There was a positive correlation be- tween body mass index and lumbar vertebra T score, femur neck Z/T (p=0,031, p=0,000, p=0,000). Among steroid users, femur neck Z score was significantly lower compared to non-steroid users (p=0,027). There was a negative correlation between disease duration and femur neck T score, i.e., bone mineral density decreased with increasing disease duration (p=0,023). There was a negative correlation between age and femur neck T score (p=0,014).

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