Introduction: Patients with inflammatory bowel disease (IBD) are at increased risk for decreased bone mass density (BMD), fractures. Preserved muscle mass is important for healthy bones. Low mean mass can be found in these patients due to immobilization, lack of physical activity and glucocorticoids. Our aim was to evaluate the presence of low BMD and muscle mass impact on it.
Methods: 64 patients with inflammatory bowel disease (40 with Crohn disease, 24 with ulcerative colitis, 35 women and 29 men, mean age 43.8+16.9 S.D., mean duration of the disease 9.1 +7.1 S.D.), were evaluated between March 2018 and March 2019. We performed dual-energy X-ray absorptiometry for BMD-spine and femoral neck (FN) and whole-body scan. Muscle mass was estimated by with ASMI (ASM/height2). Low BMD was defined according WHO as T score 2.5 S.D. in men aged >50 years and postmenopausal women, osteopenia between −1 and 2.49 S.D. and score≤−2 S.D. below the expected range for gender and sex in the other patients.
Results: 6 patients had fragility fracture, 2 young patients and 4 post-menopausal women. 4 had vertebral fractures, undiagnosed until the evaluation. According to the criteria mentioned above, low BMD was found in more than half of the patients (34/64 patients), osteoporosis in 9 patients, osteopenia in 12 patients, and BMD below the expected range in 13 patients. BMD was positively corelated with BMI (P=0.03). ASMI positively correlated with BMD both at the spine (P<0.001, r=0.445) and at the hip (P=0.028, r=0.303).
Conclusion: This study shows that, due to high frequency of bone abnormalities in patients with IBD, strategies to screen earlier in order to prevent fragility fractures should be elaborated. ASMI is an important predictor for BMD, underlining the importance of physical activity on preventing low BMD. Tests for assessment of sarcopenia are needed.