TY - JOUR
T1 - Osteoporosis in patients with intestinal insufficiency and intestinal failure
T2 - Prevalence and clinical risk factors
AU - Nygaard, Louis
AU - Skallerup, Anders
AU - Olesen, Søren Schou
AU - Køhler, Marianne
AU - Vinter-Jensen, Lars
AU - Kruse, Christian
AU - Vestergaard, Peter
AU - Rasmussen, Henrik Højgaard
N1 - Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
PY - 2018/10/1
Y1 - 2018/10/1
N2 - Background & aims: Intestinal insufficiency and intestinal failure are associated with malabsorption of micro- and macronutrients that may negatively influence bone metabolism and increase the risk for developing osteoporosis. However, information regarding prevalence and contribution of individual risk factors is scarce. We investigated the prevalence of osteoporosis in patients with intestinal insufficiency and intestinal failure and identified associated risk factors. Methods: This was a retrospective cross-sectional study including 167 clinically stable outpatients with intestinal insufficiency or intestinal failure. Bone mineral density (BMD) was measured by dual X-ray absorptiometry and the prevalence of osteoporosis was compared to a gender and age matched population. Several clinical and demographic parameters, including body mass index (BMI), vitamin-D, smoking habits and medications, were analyzed for association with BMD. Results: The prevalence of osteoporosis was 56.9% in the combined patient group compared to 24.1% in the control group (OR 4.2 [95% CI, 2.3 to 7.7]; p < 0.001). BMD in the hip was independently associated with BMI (0.13 [95% CI, 0.09 to 0.18]; p < 0.001) and vitamin-D levels (−0.41 [95% CI, −0.76 to −0.06]; p = 0.03). Similar associations were seen for BMD in the spine (0.15 [95% CI, 0.08 – 0.22]; p < 0.001) and (−0.60 [95% CI, −0.76 to −0.06]; p = 0.02), respectively. Trends for low BMD were observed in smokers, and in patients using glucocorticoids, opioids, and proton pump inhibitors. Conclusions: Patients with intestinal insufficiency and intestinal failure are at immense risk of developing osteoporosis. Low BMI and vitamin-D deficiency were identified as independent risk factors.
AB - Background & aims: Intestinal insufficiency and intestinal failure are associated with malabsorption of micro- and macronutrients that may negatively influence bone metabolism and increase the risk for developing osteoporosis. However, information regarding prevalence and contribution of individual risk factors is scarce. We investigated the prevalence of osteoporosis in patients with intestinal insufficiency and intestinal failure and identified associated risk factors. Methods: This was a retrospective cross-sectional study including 167 clinically stable outpatients with intestinal insufficiency or intestinal failure. Bone mineral density (BMD) was measured by dual X-ray absorptiometry and the prevalence of osteoporosis was compared to a gender and age matched population. Several clinical and demographic parameters, including body mass index (BMI), vitamin-D, smoking habits and medications, were analyzed for association with BMD. Results: The prevalence of osteoporosis was 56.9% in the combined patient group compared to 24.1% in the control group (OR 4.2 [95% CI, 2.3 to 7.7]; p < 0.001). BMD in the hip was independently associated with BMI (0.13 [95% CI, 0.09 to 0.18]; p < 0.001) and vitamin-D levels (−0.41 [95% CI, −0.76 to −0.06]; p = 0.03). Similar associations were seen for BMD in the spine (0.15 [95% CI, 0.08 – 0.22]; p < 0.001) and (−0.60 [95% CI, −0.76 to −0.06]; p = 0.02), respectively. Trends for low BMD were observed in smokers, and in patients using glucocorticoids, opioids, and proton pump inhibitors. Conclusions: Patients with intestinal insufficiency and intestinal failure are at immense risk of developing osteoporosis. Low BMI and vitamin-D deficiency were identified as independent risk factors.
KW - Body mass index
KW - Dual energy X-ray absorptiometry
KW - Home parenteral nutrition
KW - Intestinal failure
KW - Osteoporosis
KW - Vitamin-D
UR - http://www.scopus.com/inward/record.url?scp=85027730887&partnerID=8YFLogxK
U2 - 10.1016/j.clnu.2017.07.018
DO - 10.1016/j.clnu.2017.07.018
M3 - Journal article
C2 - 28823627
SN - 0261-5614
VL - 37
SP - 1654
EP - 1660
JO - Clinical Nutrition
JF - Clinical Nutrition
IS - 5
ER -