Inflammatory bowel disease 2750 INDEX

Osteoporosis is also common in those on long-term corticosteroid therapy (for example patients with autoimmune hepatitis or coexisting inflammatory bowel disease). Patients with chronic liver disease may also have other risk factors for osteoporosis related to their disease state. These include vitamin D deficiency, excessive alcohol consumption, poor diet, physical inactivity and low body mass index. Oestrogen deficiency in the postmenopausal stage further increases the risk. 

Susceptibility factors Inflammatory bowel disease is a susceptibility factor for abnormal bone metabolism, with a large amount of evidence of increased incidences of osteopenia and osteoporosis in adults. However, only a few studies of bone mineral density have been performed in children and adolescents with inflammatory bowel disease. Bone mineral density in the lumbar spine has been evaluated in 40 children and adolescents with inflammatory bowel disease, mean age 12 years, 26 with ulcerative colitis and 14 with Crohn s disease, in order to identify the associated susceptibility factors [15 ]. There was a low bone mineral density (Z-score worse than —2) in 25% of patients, with equal prevalences in Crohn s disease and ulcerative cohtis. Height for age, basal metabolic index, and cumulative glucocorticoid dose had independent effects, and these effects remained significant after adjustment for disease duration. 

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