Vertebral fractures in patients with inflammatory bowel disease COMPARED with a healthy population: a prospective case-control study

Vazquez MA et al. – The prevalence of morphometric vertebral fractures is higher in patients with inflammatory bowel disease (IBD) than in the healthy population, without association with bone mass density (BMD) or corticoid treatment. Simply having IBD was proven to be a predictive factor of fracture. The authors observed a high incidence of hypovitaminosis D in patients with IBD.

Methods

• A total of 107 patients with IBD (53 with Crohn's disease and 54 with ulcerative colitis) and 51 healthy subjects participated in the study.
• Information about anthropometric parameters, toxins, previous fractures, and parameters related to this disease were evaluated.
• The index of vertebral deformity, bone mass density (BMD), and biochemical parameters were calculated.

Results

• A total of 72 fractures were detected in 38.32% of patients with IBD, and 10 fractures were detected in 13.73% of healthy subjects; the risk of fracture in patients with IBD was higher than that in control subjects (OR, 4.03; 95% CI, 1.652-9.847; p < 0.002).
• The authors found no correlation between fracture and BMD in patients with IBD (lumbar spine, r=0.103, p=0.17 and femoral neck, r=0.138, p=0.07).
• Corticosteroid treatment was not associated with prevalent vertebral fractures nor with taking corticosteroids (r=0.135, p=0.14) or the duration for which they were taken (r=0.08, p=0.38), whereas this relationship was present in the controls (r=0.365, p=0.01).
• In the multivariate analysis, none of the measured parameters were significantly predictive of fracture, only to manifested IBD.
• Hypovitaminosis D was observed in 55.14% of patients with IBD.

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