Osteoporosis not prevented by ulcerative colitis surgery
MedWire New: Osteoporosis and osteopenia is as likely to develop in ulcerative colitis (UC) patients who undergo restorative proctocolectomy (RPC) as in those who do not have the procedure, researchers have found.
The study findings suggest that UC patients having RPC should be screened in line with UC guidelines, which recommend that postmenopausal women and men older than 50 years of age with inflammatory bowel disease undergo bone mineral density (BMD) measurements to exclude osteoporosis.
The findings are at odds with the American Gastroenterology Association’s guidelines statement that RPC may be associated with an improvement in BMD.
Simon McLaughlin (King’s College London, UK) and colleagues measured BMD using dual-energy X-ray absorptiometry (DXA) in 53 patients older than 50 years who had undergone RPC for UC.
Overall, 43.4% of patients had osteopenia at the either the hip or spine or at both sites, and 13.2% of patients had osteoporosis. Normal BMD was found in 43.4% of patients.
The researchers note the prevalence of osteoporosis and osteopenia found in the present study “is comparable to that reported in studies of UC patients who had not been operated on, in which rates of osteoporosis and osteopenia have ranged from 4% to 50% and from 32% to 67%, respectively.”
McLaughlin and team further found that age at RPC was significantly and negatively correlated with BMD, and the median age at RPC was 45 years. A negative correlation was also seen with age at the time of the DXA scan, but this was determined as nonsignificant.
“Given the high prevalence of osteopenia in the population studied, clinicians should ensure that RPC patients older than age 50 maintain an adequate calcium and vitamin D intake or consider supplementation when this is not practical,” conclude the authors in the journal Inflammatory Bowel Disease.
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By Ingrid Grasmo