Erdal DİLEKCİ, Ahmet TEZEL, Güray CAN, Mehmet Emin DEMİRKOL, Esra Nur Ademoğlu DİLEKÇİ, Müjgan GÜRLER, Edip ERKUŞ, Gülbin ÜNSAL, Ali SOYLU, Hasan Celalettin ÜMİT, Meral AKDOĞAN KAYHAN, Mehmet KAYHAN, Çağlar KESKİN

İnflamatuvar Barsak Hastalıklarında Osteoporoz Sıklığı

İnflamatuvar barsak hastalıkları, ağırlıklı olarak gastrointestinal sistemi tutan sistemik kronik inflamatuvar bir hastalık grubudur. İnflamatuvar barsak hastalıklarında ekstraintestinal bulgular sıklıkla birlikte bulunmaktadır. Bunlar içinde metabolik kemik hastalıkları azımsanmayacak ölçüde sıktır. Çalışmamızda kendi inflamatuvar barsak hastalıkları kohortumuzda osteoporoz ve osteopeni sıklığını ortaya koymayı amaçladık. Bu çalışmaya 71 ülseratif kolit, 44 Crohn hastasının kemik mineral dansite verileri retrospektif olarak değerlendirildi. İnflamatuvar barsak hastalığında tanı, tutulum paterni, hastalık davranışı, cinsiyet ve kemik mineral dansite lokalizasyonlarına göre kemik dansiteleri, T ve Z skorları karşılaştırıldı. Ülseratif kolit hastalarının %53,5’inde, Crohn hastalarının %50’sinde osteopeni saptandı. Ülseratif kolit ile Crohn hastalığı arasında anlamlı fark yoktu. Ülseratif kolit hastalarının %22,5’inde, Crohn hastalarının %25’inde osteoporoz saptandı. Ülseratif kolit ile Crohn hastalığı arasında anlamlı fark yoktu. Crohn hastalığında osteopeni en sık femur boynu ve wards üçgeninde (%47,7 ve %47,7), ülseratif kolit hastalarında osteopeni en sık wards üçgeninde (%52,1) saptandı. Ülseratif kolit ve Crohn hastalığında osteoporoz en sık lomber bölgede (sırasıyla %15,5 ve %18,2) tespit edildi. Ülseratif kolit ve Crohn hastalığı arasında osteoporoz ve osteopeni açısından anlamlı fark izlenmedi. Ülseratif kolit ve Crohn hastalığında alttip, davranış, cinsiyet ve kemik mineral dansite lokalizasyon açısından karşılaştırıldığında anlamlı fark saptanmadı. İnflamatuvar barsak hastalığında osteoporoz ve osteopeni sıklığı artmıştır. Bulgularımızı doğrulamak için daha büyük örneklem büyüklüğüyle ve iyi dizayn edilmiş prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler:

İnflamatuvar barsak hastalığı, metabolik kemik hastalığı, osteoporoz, osteopeni

Osteoporosis in Inflammatory Bowel Diseases

Inflammatory bowel disease is a group of systemic chronic inflammatory disease that predominantly affects the gastrointestinal tract. Extraintestinal findings are frequently together in inflammatory bowel disease. Of these, metabolic bone diseases are considerably frequent. In our study, we aimed to reveal the frequency of osteoporosis and osteopenia in our own inflammatory bowel disease cohort. In this study, 71 ulcerative colitis and 44 bone mineral density data of Crohn's patients were retrospectively evaluated. Bone densities, T and Z scores were compared according to involvement pattern, diagnosis, disease behavior, gender and bone mineral density localizations in inflammatory bowel disease . Osteopenia and osteoporosis were detected in 53,5% and 22,5% of ulcerative colitis patients and in 50% and 25% of Crohn's patients respectively. There was no significant difference between ulcerative colitis and Crohn's patients. In Crohn's patients, osteopenia was most frequently detected in the femur neck by 47,7% and in the wards triangle by 47,7%, in the ulcerative colitis, osteopenia was most frequently detected in the wards triangle (52,1%). In the ulcerative colitis and Crohn's patients, osteoporosis was most frequently detected in lumbar region ( respectively 15,5% and 18,2%). There was no significant difference between ulcerative colitis and Crohn's patients in terms of osteopenia and osteoporosis. There was no significant difference in ulcerative colitis and Crohn's patients when compared in terms of subtype, behavior, gender and localization of bone mineral density. The frequencies of osteoporosis and osteopenia increase in inflammatory bowel disease. Larger sample sizes and well-designed prospective studies are needed to confirm our findings.

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