Silva AP, Karunanayake AL, Dissanayaka TGI, Dassanayake AS, Duminda HKKT, Pathmeswaran A, Wickramasinghe AR, Silva HJ. Osteoporosis in adult Sri Lankan inflammatory bowel disease patients. World J Gastroenterol 2009; 15(28): 3528-3531 [PMID: 19630109 DOI: 10.3748/wjg.15.3528]
Corresponding Author of This Article
Dr. Arjuna Priyadarsin de Silva, Department of Medicine, Faculty of Medicine, University of Kelaniya, PO Box 6, Thalagolla Road, Ragama GQ11010, Sri Lanka. apdsilva@yahoo.com
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Brief Article
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Arjuna Priyadarsin de Silva, Thalahitiya Gamaralalage Iruka Dissanayaka, Hewa Kattadi Kankanamgae Tilak Duminda, Hithanadura Janaka de Silva, Department of Medicine, Culty of Medicine, University of Kelaniya, PO Box 6, Thalagolla Road, Ragama GQ11010, Sri Lanka
Aranjan Lionel Karunanayake, Department of Anatomy, Faculty of Medicine, University of Kelaniya, PO Box 6, Thalagolla Road, Ragama GQ11010, Sri Lanka
Anuradha Supun Dassanayake, Department of Pharmacology, Faculty of Medicine, University of Kelaniya, PO Box 6, Thalagolla Road, Ragama GQ11010, Sri Lanka
Arunasalam Pathmeswaran, Department of Public Health, Faculty of Medicine, University of Kelaniya, PO Box 6, Thalagolla Road, Ragama GQ11010, Sri Lanka
Ananda Rajitha Wickramasinghe, Faculty of Medicine, University of Kelaniya, PO Box 6, Thalagolla Road, Ragama GQ11010, Sri Lanka
Author contributions: de Silva AP, Wickramasinghe AR and de Silva HJ were involved in conceptualizing the study and writing the manuscript; Karunanayake AL performed DEXA scanning; Dissanayaka TGI and Duminda HKKT was involved data gathering; Pathmeswaran A was involved in statistical analysis; Dassanayake AS was involved in all clinical care of patients; All authors read the manuscript and helped in editing the final copy.
Correspondence to: Dr. Arjuna Priyadarsin de Silva, Department of Medicine, Faculty of Medicine, University of Kelaniya, PO Box 6, Thalagolla Road, Ragama GQ11010, Sri Lanka. apdsilva@yahoo.com
Telephone: +94-11-2953409
Fax: +94-11-2958337
Received: May 10, 2009 Revised: June 17, 2009 Accepted: June 24, 2009 Published online: July 28, 2009
Abstract
AIM: To determine if inflammatory bowel disease (IBD) is a risk factor for osteoporosis in adult Sri Lankans.
METHODS: We identified eligible subjects from among consecutive patients diagnosed with IBD who attended our outpatient clinic. We included only patients aged between 20 and 70 years. Patients who were pregnant, had significant comorbidity, or were on calcium supplements or treatment for osteoporosis within the past 6 mo, were excluded. Healthy, age- and sex-matched controls were also recruited, in a control to patient ratio of 3:1. Both groups were screened for osteoporosis using peripheral dual energy X-ray absorptiometry scanning.
RESULTS: The study population consisted of 111 IBD patients (male:female = 43:68; mean age 42.5 years) and 333 controls (male:female = 129:204; mean age 43.8 years). The occurrence of osteoporosis among IBD patients (13.5%) was significantly higher than among controls (4.5%) (P = 0.001). The frequency of osteoporosis was not significantly different between ulcerative colitis (14.45%) and Crohn’s disease (10.7%). However, on multivariate analysis, only age (P = 0.001), menopause (P = 0.024) and use of systemic steroids (P < 0.001) were found to be associated independently with the occurrence of osteoporosis, while IBD, severity of disease, number of relapses, duration of illness or treatment other than systemic steroids were not.
CONCLUSION: IBD does not appear to be an independent risk factor for the occurrence of osteoporosis in this population. However, the use of systemic steroids was a risk factor.
