AB0891 Prevalence of Osteoporosis and Vitamin D Deficiency in Patients with Inflammatory Bowel Disease
Authors: D. Rosa-Gonçalves, M. Bernardes, T.S. Vieira, F. Magro, G. Macedo, A. Oliveira, T. Faria, V. Alves, M.B. Perez, A.S. Pinto, I. Ramos, J.G. Pereira, L. Costa
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> The inflammatory bowel disease (IBD) increases the risk for metabolic bone disease due to several factors, including steroid use, increased cytokine production and malabsorption. <h3>Objectives</h3> Determine prevalence of osteopenia/osteoporosis (OP) in IBD patients, characterizing their bone metabolism profile.We also intend evaluate correlation between bone mineral density (BMD) and T-score with bone biomarkers (BBM), 25(OH)D3 levels and use of steroids. <h3>Methods</h3> Cross-sectional study was conducted in adult IBD patients from a University Hospital in the North of Portugal. Patients who exhibited a controlled IBD were evaluated consecutively by a rheumatologist from June 2013 to December 2014. Age,IBD duration and treatment data were collected. Lumbar spine (LS) and total hip (TH) BMD were analyzed using osteo-densitometer LUNAR Expert 1320. We determined phosphorus<i>,</i> calcium, parathormone (PTH), 25(OH)D3 and BBM (beta-<i>CTx,</i>osteocalcin) levels in the serum. Descriptive statistics was used to report sample9s demographic and clinical characteristics. Pearson9s correlation was used to evaluate correlation between BMD and T-score with BBM and 25(OH)D3 levels;student t-test was used to evaluate relation with history of use of high-dose steroids. Statistical significance level was set at p&lt;0.05. <h3>Results</h3> Total of 57patients were included, with a mean age of 44 years-old (±11.84), the majority females (n=36). Thirty-seven (64.9%) had CD and 20 (35.1%) UC. Mean duration of IBD was 11.95 (±7.71) years. Twenty-six (45.6%) were under biological therapy due to IBD (25 infliximab; 1 adalimumab). Other therapies in use were azathioprine, sulphasalazine and mesalazine. Only 3 patients were under steroids (&lt;10mg/d prednisolone) but 17 patients had a past history of high-dose steroids use. Osteopenia prevalence ranged from 21% (n=12) (TH) to 24.6% (n=14) (LS).The prevalence of OP ranged from 5.3% (n=3) (TH) to 7% (n=4) (LS). Eleven (19.3%) patients had 25 (OH)D3 levels between 20-30ng/mL and 36 (63.2%) had &lt;20ng/mL. Eight (14%) patients had PTH levels &gt;65pg/mL, of which 3 had hipophosphatemia. Seven (12.3%) patients exhibited high bone turn-over (beta-<i>CTx</i>≥0.28ng/mL <i>and</i> osteocalcin≥31.2ng/mL). Additionally, 25 patients presented with beta-<i>CTx</i>≥0.28ng/mL. Beta-<i>CTx</i> was correlated with LS and TH T-scores (r=-0.348 and r=-0.303, respectively; p&lt;0.05) and BMD values (r=-0.340 and r=-0.297, respectively; p&lt;0.05). Similarly, osteocalcin was correlated significantly with LS and TH T-scores (r=-0.454 and r=-0.443, respectively; p&lt;0.01) and BMD values (r=-0.472 and r=-0.459, respectively; p&lt;0.01).BMD values and T-score on LS and TH weren9t correlated with the disease duration, 25(OH)D3 levels or acute phase reactants.We found that the use of high-doses steroids has a significant effect on BMD and T-score of the TH (p&lt;0.05 for both) but not on the LS (p=0.065 and p=0.093, respectively). <h3>Conclusions</h3> High prevalence of osteopenia/osteoporosis and lower serum 25(OH)D3 levels were observed, in both CD and UC patients. The early recognition of problem and more appropriate preventive and treatment strategies are essential. <h3>Disclosure of Interest</h3> None declared