Bone Disease in Male Veterans with Ulcerative Colitis: 10-Year Nationwide Study

Abstract

Purpose: Low Bone mineral density (BMD) are common in patients with inflammatory bowel diseases and is a leading causes of morbidity in such patients. Data about bone disease in male UC patients is scarce. Or aim was to assess the prevalence of low BMD among male UC patients on a nationwide level. Methods: Nationwide data was obtained from the Veterans Affairs (VA) healthcare system. Male veterans seen by the VA between 2001-2011 were identified using ICD-9 and were included in our analysis. Automated data extraction captured information about the veterans demographics, presence of bone disease and most important risk factors [corticosteroid (CS) use, hyperparathyroidism, hypogonadism, malnutrition, vitamin D deficiency and smoking]. The rate of bone disease by cumulative CS decile was calculated. Multivariate logistic regression analysis was used to identify the independent effect of each factor on bone disease. Results: We included 34,665 male UC patients (mean age 66, Caucasians 75%). Prevalence of osteoporosis among the included population was 6.5%, while for osteopenia it was 4.3%. Those who used CS (30% of the included population with mean duration of 9 months) had higher prevalence of bone diseases (10.2% and 7%) compared to those who did not use CS (4.8% and 3.2%) for osteoporosis and osteopenia respectively, p<0.001. By using multivariate analysis, we found that cumulative oral CS deciles was the most significant predictor of bone disease and showed a significant trend (dose-response) pattern even in those with lowest decile of cumulative CS exposure, Table 1.Table 1: Multivariate logistic regression analysis, outcome is having bone disease (osteoporosis or osteopenia)Conclusion: In this large nationwide male UC cohort, 41% of those in the highest CS use decile had osteoporosis or osteopenia. CS use is the most important independent risk factor for low bone density among UC male patients. Efforts should be taken to reduce CS utilization among these patients by using other immunosuppressant agents.