Abstract
Background: Bone impairment of multifactorial etiology is a common feature in inflammatory bowel disease (IBD). Body composition parameters, which might be selectively modified in these patients, are important determinants of bone strength. Our aim was to investigate the relationship between components of body composition and bone parameters in IBD patients. Methods: This is a cross-sectional, retrospective study including 80 IBD patients (43 women, 37 men). Lumbar spine (LS), femoral neck (FN) and whole body DXA scans were performed to analyze regional bone mineral density (BMD), as well as body composition, including appendicular skeletal muscle mass index (ASMI), total and visceral fat mass (VAT). Trabecular bone score (TBS) was assessed using iNsight Software. Results: Twenty (25%) IBD patients had inadequate LS-BMD z scores (<=−2DS). Lean mass (LM) was a significant determinant of LS-BMD, after adjusting for age, gender, BMI and fat mass (p < 0.01), while fat mass% remained associated with FN-BMD (p < 0.01). TBS correlated positively with BMI (r = 0.24, p < 0.05), LS-BMD (r = 0.56, p < 0.001), ASMI (r = 0.34, p < 0.001) and negatively with VAT/total fat% (r = −0.27, p < 0.05). Multivariate analysis showed that ASMI, LS-BMD (positively) and VAT/total fat% (negatively) were independently associated with TBS. Conclusions: In IBD patients, skeletal muscle mass and fat percentage and distribution are important factors associated with bone health.
Highlights
Inflammatory bowel disease (IBD), which comprises Crohn’s disease (CD) and ulcerative colitis (UC), represents a chronic inflammatory condition associated with a significant impairment in all aspects of an individual’s life [1]
There were no significant differences between men and women regarding age, type of disease or the majority of bone densitometry parameters (LS and hip bone mineral density (BMD) z scores, Trabecular bone score (TBS))
No difference regarding bone impairment prevalence was observed between CD and UC patients, or between men and women
Summary
Inflammatory bowel disease (IBD), which comprises Crohn’s disease (CD) and ulcerative colitis (UC), represents a chronic inflammatory condition associated with a significant impairment in all aspects of an individual’s life [1]. Prone to malabsorption and malnutrition due to multiple factors (chronic inflammatory disease, increased risk for surgeries and low oral intake secondary to anorexia as well s diarrhea), about 15–40% of IBD patients are obese [2] and a significant number have abnormalities in body composition [3]. The impact of body mass index (BMI) on bone mineral density (BMD) is well known, and for many years, increased body weight was regarded as a protective factor against bone impairment [6]. Lumbar spine (LS), femoral neck (FN) and whole body DXA scans were performed to analyze regional bone mineral density (BMD), as well as body composition, including appendicular skeletal muscle mass index (ASMI), total and visceral fat mass (VAT).
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