Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
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Advances in Clinical and Experimental Medicine

2016, vol. 25, nr 1, January-February, p. 185–190

doi: 10.17219/acem/33746

Publication type: review

Language: English

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Osteoporosis in Gastrointestinal Diseases

Iwona Krela-Kaźmierczak1,A,E, Aleksandra Szymczak1,B, Liliana Łykowska-Szuber1,D, Piotr Eder1,C, Krzysztof Linke1,F

1 Department of Gastroenterology, Human Nutrition and Internal Diseases, Poznan University of Medical Sciences, Poland

Abstract

Secondary osteoporosis occurs as an isolated pathology or co-exists with types I and II osteoporosis. The gastroenterologist may come across osteoporosis or osteopenia in a patient with a gastrointestinal disease. This is often a young patient in whom investigations should be carried out and appropriate treatment initiated, aimed at preventing bone fractures and the formation of the best peak bone mass. Osteoporosis occurs in patients with the following conditions: Crohn’s disease, ulcerative colitis, celiac disease, post gastrectomy patients, patients with short bowel syndrome, chronic hepatitis and cirrhosis, treated with steroids (steroid-induced osteoporosis) and patients using proton pump inhibitors chronically (state of achlorhydria). It is therefore necessary to approve a list of risk factors of secondary osteoporosis, the presence of which would be an indication for screening for osteoporosis, including a DXA study and the development of a separate algorithm for the therapeutic management of secondary osteoporosis accompanying gastrointestinal diseases, especially in premenopausal young women and young men, because there are currently no registered drugs with proven antifracture activity for this group of patients.

Key words

bone mineral density, osteoporosis, gastrointestinal disorders

References (35)

  1. Brent RJ, Kavvoura FK, Rivadeneira F: Collaborative meta-analysis: associations of 150 candidate genes with osteoporosis and osteoporotic fracture. Ann Intern Med 2009, 151, 528–537.
  2. Hofbauer LC, Schoppet M: Clinical implications of the osteoprotegerin/RANKL/RANK system for bone and vascular diseases. JAMA 2004, 292, 490–495.
  3. Holick MF: Vitamin D deficiency. N Engl J Med 2007, 357, 266–281.
  4. Ghosh S, Cowen S, Hannan WJ: Low bone mineral density in Crohn’s disease, but not in ulcerative colitis, at diagnosis. Gastroenterology 1994, 107, 1031–1039.
  5. Bernstein CN, Leslie WD, Leboff MS: AGA technical review on osteoporosis in gastrointestinal diseases. Gastroenterology 2003, 124, 795–841.
  6. Seymour K, Weinerman S: Osteoporosis and Gastrointestinal Disease. Gastroenterol Hepatol (NY) 2010, 6, 505–517.
  7. Bernstein CN, Blanchard JF, Leslie W: The incidence of fracture among patients with inflammatory bowel disease. A population-based cohort study. Ann Intern Med 2000, 33, 795–799.
  8. Van Staa TP, Cooper C, Brusse LS: Inflammatory bowel disease and the risk of fracture. Gastroenterology 2003, 125, 1591–1597.
  9. Vestergaard P, Mosekilde L: Fracture risk in patients with celiac Disease, Crohn’s disease, and ulcerative colitis: a nationwide follow-up study of 16,416 patients in Denmark. Am J Epidemiol 2002, 156, 1–10.
  10. Frei P, Fried M, Hungerbuhler V: Analysis of risk factors for low bone mineral density in inflammatory bowel disease. Digestion 2006, 73, 40–46. Epub 2006 Mar 14.
  11. Bours PHA: Seasonal variation of serum 25-hydroxyvitamin D levels in adult patients with inflammatory bowel disease. Osteoporos Int 2011, 22, 2857–2867.
  12. Guidelines for osteoporosis in inflammatory bowel disease and celiac disease written and approved by the British Society of Gastroenterology. June 2007 www.bsg.org.uk.
  13. Stenson WF: Increased prevalance of celiac disease and need for routine screening among patients with osteoporosis. Arch Intern Med 2005, 165, 393–399.
  14. Mulder ChJ: Celiac Disease Presenting as Severe Osteopenia. Hawaii Med J 2011, 70, 242–244.
  15. Melton et al: Fracture risk after surgery for peptic ulcer disease: a population-based cohort study. Bone 1999, 25, 53, 851–860.
  16. Solaymani-Dodaran M, Card TR, Aithal GP: Fracture risk in people with primary biliary cirrhosis: a populationbased cohort study. Gastroenterology 2006, 131, 1752–1757.
  17. Boulton-Jones JR: Fracture risk of woman with primary biliary cirrhosis: no increase compared with general population controls. Aliment Pharmacol Ther 2004, 20, 551–557.
  18. Ninkovic M, Love SA, Tom B: High prevalence of osteoporosis in patients with chronic liver disease prior to liver transplantation. Calcif Tissue Int 2001, 69, 321–326.
  19. Compston JE: Osteoporosis after liver transplantation. Liver Transp 2003, 9, 321–330.
  20. American Gastroenterological Association medical position statement: Osteoporosis in hepatic disorders. Gastroenterology 2003, 125, 937–940.
  21. Canalis E: Osteoporosis Int 2007, 18, 1319.
  22. Delany AM: The cellular and molecular basis for glucocorticoid actions in bone. Front Horm Res 2002, 30, 2–12.
  23. Lukert BP: Glucocorticoid and Drug-Induced Osteoporosis. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. Lippincott-Raven 1996, 278–283.
  24. Canalis E, Mazziotti G, Giustina A: Glucocorticoid-induced osteoporosis: pathophysiology and therapy E. Osteoporosis International 2007, 18, 1319–1328.
  25. Shelly L, LaCroix A, Larson J: Proton pump inhibitor use, hip fracture, and change in Bone Mineral Density in postmenopausal women. Results from the women’s health initiative. Arch Intern Med 2010, 170, 765–771.
  26. Meunier PJ, Roux C, Seeman E: The effects of strontium ranelate on the risk of vertebral fracture in women with postmenopausal osteoporosis. N Engl J Med 2004, 350, 459–468.
  27. Register JY: Strontium ranelate reduces the risk of nonvertebral fractures in postmenopausal women with osteoporosis; treatment of peripherial osteoporosis (TROPOS) study. J Clin Endocrinol Metab 2005, 90, 2816–2822.
  28. Seeman E: Strontium ranelate reduces the risk of vertebral and nonvertebral fractures in aged eighty years and over. J Bone Miner Res 2006, 21, 1113–1120.
  29. Miheller P, Muzes G, Zogoni T: Improvement of bone metabolism after infliximab therapy in Crohn’s disease. Orv Hetil 2005, 146, 1477–1480.
  30. Cummings SR, San Martin J, McClung M: Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 2009, 361, 756–765.
  31. Bekker PJ, Holloway DL, Rasmussen AS: A single-dose placebo-controlled study of AMG 162, a fully human monoclonal antibody to RANKL, in postmenopausal women. J Bone Miner Res 2004, 19, 1059–1066.
  32. Elliott R, Kostenuik P, Chen C: Denosumab is a selective inhibitor of human receptor activator of NF-Kb ligand (RNKL) that blocks osteoclast formation and function. Osteoporos Int 2007, 18, S54. Abstract P149.
  33. McClung MR: Denosumab in postmenopausal women with low bone mineral density. N Engl J Med 2006, 354, 821–831.
  34. Cummings SR, San Martin J, McClung MR: Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 2009, 361, 756–765.
  35. Przedlacki J: Secondary osteoporosis in adult. Warszawa 2007.
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