Yuga Komaki1,2, Fukiko Komaki1,3, Dejan Micic1, Akio Ido3, Atsushi Sakuraba1. 1. Department of Medicine, Inflammatory Bowel Disease Center, The University of Chicago Medicine, Chicago, IL. 2. Section of Gastroenterology, Fujimoto General Hospital, Miyakonojo. 3. Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Abstract
BACKGROUND: Studies assessing the risk of fractures in inflammatory bowel diseases (IBD) have shown controversial results. GOALS: We performed a systematic review and meta-analysis to assess the risk of fractures in IBD. STUDY: Electronic databases were searched for cohort studies assessing the risk of fractures in IBD. The outcomes were the risk of overall fractures and at specific sites, and the association between the risk of fractures and the proportion of patients with corticosteroid use or osteoporosis. RESULTS: Ten studies including 470,541 patients were identified. The risk of overall fractures in IBD patients was similar to controls [odds ratio (OR), 1.08; P=0.70; 95% confidence interval (CI), 0.72-1.62) with moderate heterogeneity (I=74.4%) which appeared to be due to the variable power and outcomes among the studies. The OR of fractures at the spine was significantly elevated at 2.21 (P<0.0001; 95% CI, 1.39-3.50) with low heterogeneity (I=26.1%). Meta-regression showed a correlation with the proportion of patients with steroid use. Risks of fractures at other sites (hip, rib, and wrist) were not elevated. Patients with fractures were more commonly on steroids compared with those without fractures (OR, 1.47; P=0.057; 95% CI, 0.99-2.20; I<0.0001%), but there was no correlation with osteoporosis. CONCLUSIONS: IBD patients had no increased risk of overall fractures, but were at significantly increased risk of fractures at the spine, which was associated with steroid use. Strict surveillance and prevention of spine fractures are indicated in patients with IBD.
BACKGROUND: Studies assessing the risk of fractures in inflammatory bowel diseases (IBD) have shown controversial results. GOALS: We performed a systematic review and meta-analysis to assess the risk of fractures in IBD. STUDY: Electronic databases were searched for cohort studies assessing the risk of fractures in IBD. The outcomes were the risk of overall fractures and at specific sites, and the association between the risk of fractures and the proportion of patients with corticosteroid use or osteoporosis. RESULTS: Ten studies including 470,541 patients were identified. The risk of overall fractures in IBDpatients was similar to controls [odds ratio (OR), 1.08; P=0.70; 95% confidence interval (CI), 0.72-1.62) with moderate heterogeneity (I=74.4%) which appeared to be due to the variable power and outcomes among the studies. The OR of fractures at the spine was significantly elevated at 2.21 (P<0.0001; 95% CI, 1.39-3.50) with low heterogeneity (I=26.1%). Meta-regression showed a correlation with the proportion of patients with steroid use. Risks of fractures at other sites (hip, rib, and wrist) were not elevated. Patients with fractures were more commonly on steroids compared with those without fractures (OR, 1.47; P=0.057; 95% CI, 0.99-2.20; I<0.0001%), but there was no correlation with osteoporosis. CONCLUSIONS:IBDpatients had no increased risk of overall fractures, but were at significantly increased risk of fractures at the spine, which was associated with steroid use. Strict surveillance and prevention of spine fractures are indicated in patients with IBD.
Authors: Dolores Sgambato; Francesca Gimigliano; Cristiana De Musis; Antimo Moretti; Giuseppe Toro; Emanuele Ferrante; Agnese Miranda; Domenico De Mauro; Lorenzo Romano; Giovanni Iolascon; Marco Romano Journal: World J Clin Cases Date: 2019-08-06 Impact factor: 1.337
Authors: Anna Maria Rychter; Alicja Ewa Ratajczak; Aleksandra Szymczak-Tomczak; Michał Michalak; Piotr Eder; Agnieszka Dobrowolska; Iwona Krela-Kaźmierczak Journal: Nutrients Date: 2021-05-30 Impact factor: 5.717