P-019 Factors Associated with Decreased Bone Mineral Density in Patients with Crohn's Disease

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Abstract

Background:

Osteoporosis and osteopenia are multifactorial diseases, affecting up to 42% of patients with Crohn's disease (CD). The main risk factors for these conditions are females, use of steroids, disease duration, inflammatory activity, loss of lean mass and malnutrition associated with inadequate absorption of calcium and vitamin D. The aim this study was to correlate bone mineral density, body composition and inflammatory activity in patients with DC.

Methods:

Fifty patients with CD were submitted to Dual Energy X-Ray Absorptiometry (DEXA), in order to estimate bone mineral density, body composition and body fat. Crohn's Disease Activity Index (CDAI), C-reactive protein levels (CRP), smoking and use of steroids were also evaluated.

Results:

The median age of patients was 41.04 ± 13.32 years, and 27 (54%) were male. The median CDAI was 87.72 ± 71.04, with 81% of the patients in clinical remission (CDAI < 150). Non-smokers were 76% of the population studied, while 14% used steroids within the past 12 months. Median CRP levels were 3.05 ± 0.87 mg/dL. Body fat median percentage was 30.9 in women and 20.2 in men. Visceral fat estimation was 830.00 ± 495 grams for female patients and 899.37 ± 729 grams for male patients. Prevalence of osteopenia and osteoporosis in femur and spine according to Z-score was 24% and 28%, respectively. In multivariate analysis, the lower the femur Z-score reaches, the higher are PCR levels (P = 0.0169) and visceral fat (P = 0.0177), and lower is the age (P = 0.0192). In logistic regression model, the increase of one single unit in PCR level, leads to higher risk of osteopenia/osteoporosis (OR = 1.292; P = 0.0172). There was a 6-fold increased risk of osteopenia/osteoporosis in the femur with the use of steroids (OR = 5.83; P = 0.0399).

Conclusions:

Conclusion: Increased visceral fat, elevated CRP levels and use of steroids are associated with osteopenia/osteoporosis in DC.

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