Tahir BURAN, ELMAS KASAP, Büşra GÖKÇE, FİKRİYE GÜL GÜMÜŞER

Ülseratif kolit hastalığı kemik mineral yoğunluğunu etkiler mi?

Giriş: İnflamatuvar barsak hastalığı(İBH) olan hastalarda kemik mineral kaybı(KMK) normal popülasyon ile karşılaştırıldığında daha yüksek (%32 -77) görülmektedir. İBH‘lı hastalarda düşük kemik yoğunluğu hem erkek hem kadınlarda görülmekte ve erken yaşlarda ortaya çıkabilmektedir. Ayrıca kortikosteroid kullanımı KMK nedeni olabilmektedir.Amaç: Ülseratif Kolitli(ÜK) hastalarda osteopeni ve osteoporoz sıklığını, hastalık yaşı, hastalık tutulum yeri, hastalık aktivitesi, cinsiyet ve steroid kullanımı ile osteopeni ve osteoporoz arasında ilişki olup olmadığını tesbit etmeyi amaçladık.Materyel ve Metod: Çalışmamıza Ocak 2014 ile şubat 2018 tarihleri arasında Manisa Celal Bayar üniversitesi Tıp Fakültesi Gastroenteroloji Kliniğine başvuran ve tarafımızdan takip edilen 15’i erkek, 21’i kadın toplam 36 ÜK hastası alındı. Bu hastaların Kemik mineral yoğunluğu(KMY) DEXA cihazı ile ölçüldü, retrospektif olarak kayıtları incelendi. Hastalık tanısı klinik bulgular, kolonoskopi ve histopatoloji ile konuldu. Tüm hastalara DEXA DPX-PRO(GE-LUNAR DPX-NT) ile APspine(vertebra) ve femur boynu kemik mineral dansitometre ölçümü yapıldı. T skor değerleri >-1 normal, -1>T>-2.5 osteopeni, T<-2,5 değerler osteoporoz olarak değerlendirildi.Hastalar; klinik aktivite, tutulum yeri, cinsiyet, steroid kullanımı, hastalık yaşı açısından değerlendirildi. Tüm hastaların KMY ölçülerek bu parametreler ile ilişkileri araştırıldı. Bulgular: Çalışmaya alınan erkek hastaların yaş ortalamaları :46.66, kadın hastaların yaş ortalaması :46.52 idı. Erkeklerin 7’sinde(%46.6), kadınların 10’unda(%47.6) osteopeni tesbit edildi. Ayrıca 1 erkek hastada(%3) ve 2 kadın hastada(%9.5) osteoporoz saptandı, hiçbir hastada kemik kırığı yoktu.Osteopoz tanısı konulan 3 hastanın 1’inde( %33) Pankolit, 2’sinde (%66) proktitis mevcuttu. Osteopeni tesbit edilen 17 hastanın 6’sında(%35,3) pankolit, 10’unda(%58.8) proktit mevcuttu.Aktif ÜK olan 33 hastanın 20’sinde(%60.6 KMK (17’si osteopeni, 3’ü osteoporoz) tesbit edildi, 13’ünde(%39.4) ise KMK yoktu. İnaktif koliti olan 3 hastanın birinde KMK tesbit edildi, Sonuç: Kadınlarda aktif ÜK de KMK daha fazlaydı. Ayrıca Aktif ÜK’i olan hastaların %55.55’sında kemik mineral bozukluğu mevcut olup hastalık aktivitesi ile KMK arasında pozitif ilişki tesbit edilmedi. Kolon tutulum yeri ile KMK arasında fark yoktu . Ayrıca Kortikosteroid kullanımı ile KMK arasında ise pozitif bir ilişki bulunamadı.Anahtar Kelimeler: Ülseratif Kolit, Osteoporoz, osteopeni, kemik mineral dansitesi Does Ulcerative Colitis Affect Bone Mineral Density? Aim: The aim of this study was to determine the frequency of osteopenia and osteoporosis in ulcerative colitis (UC) patients and the relationship between disease age, disease incidence, disease activity, sex and steroid use, osteopenia and osteoporosis.Materials and Methods: 36 patients (15 men and 21 women with ulcerative colitis) who were admitted to the Gastroenterology Clinic of Manisa Celal Bayar University Faculty of Medicine between January 2014 and February 2018 and whose bone mineral density was measured (DEXA) were included in the study. retrospectively reviewed their records.Patients; Clinical activity was assessed in terms of location, sex, steroid use, and age of the disease. Bone mineral density of all patients was measured and their relationship with these parameters was investigated.Findings: A total of 36 patients with ulcerative colitis who were measured bone mineral density were included in the study. 15 of these patients were male (mean age: 46.66) and 21 were female (mean age: 46.52). Osteopenia was detected in 7 (46.6%) of the males and 10 (47.6%) of the females. In addition, osteoporosis was detected in 1 male patient (3%) and 2 female patients (9.5%) and no bone fracture was observed in any patient.Bone mineral deficiency (17% osteopenia, 3 osteoporosis) was detected in 20 of 33 patients with active ulcerative colitis (60.6%) and bone mineral loss (BMD) was absent in 13 patients (39.4%). bone mineral loss was detected in one, not in two.Conclusion: Female ulcerative colitis bone mineral loss was greater in women. In addition, bone mineral deficiency was found in 55.55% of patients with active ulcerative colitis and there wasn’t a positive relationship between disease activity and BMD. There was also no positive correlation between corticosteroid use and BMD. Keywords: Ulcerative colitis, Osteoporosis, osteopenia, bone mineral density

Anahtar Kelimeler:

ülseratif kolit, kemik mineral yoğunluğu

Ülseratif kolit hastalığı kemik mineral yoğunluğunu etkiler mi?

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