A Case-Control Study on Risk Factors of Osteoporosis in Patients with Crohnʹs Disease

Background: Osteoporosis has been frequently reported in patients with inflammatory bowel diseases, especially Crohn’s disease. Methods: All consecutive Crohn’s disease patients who attended the GI Clinics at Shariati Hospital, Tehran, Iran, from 2004 to 2007 were evaluated. A BMD-DEXA assessment was performed for all patients. Among those patients diagnosed with osteoporosis (T score ≤ -2.5 SD), 30 patients were chosen as study cases. Of those who were not diagnosed with osteoporosis, 85 were chosen as the control group. A thorough patient history including: age, sex, body mass index, cumulative corticosteroid dose, previous fracture, history of bowel resection, site and duration of disease, smoking and consumption of calcium and vitamin D, was taken from all patients through a face-toface interview. Independent sample Student’s t-test, Chi-square, and logistic regression analyses were used for data analysis. Results: In this study, a multivariable modeling technique revealed a higher osteoporosis risk in those who had a lower body mass index, previous fractures and longer disease duration. A cumulative corticosteroid dose of 10 – 35 g provided the highest osteoporosis risk. Age, sex, bowel resection, site of disease, smoking and consumption of calcium and vitamin D did not show any relationship with osteoporosis. Conclusion: The highest osteoporosis risk was seen in patients with a cumulative 10 – 35 g corticosteroid dose and could be due to both steroid inefficiency in reducing Crohn’s disease inflammation as well as the cumulative drug dose and it’s adverse effect on patients.