Observational Study
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Jul 5, 2022; 13(4): 57-66
Published online Jul 5, 2022. doi: 10.4292/wjgpt.v13.i4.57
Overweight and abdominal fat are associated with normal bone mineral density in patients with ulcerative colitis
Mirella Brasil Lopes, Andre Castro Lyra, Raquel Rocha, Fernanda Gomes Coqueiro, Carla Andrade Lima, Carolina Cunha de Oliveira, Genoile Oliveira Santana
Mirella Brasil Lopes, Andre Castro Lyra, Carla Andrade Lima, Genoile Oliveira Santana, Programa de Pós-graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador 40110-060, Brazil
Raquel Rocha, Fernanda Gomes Coqueiro, Departamento Ciências da Nutrição, Universidade Federal da Bahia, Salvador 40110-060, Brazil
Carolina Cunha de Oliveira, Departamento de Nutrição, Universidade Federal de Sergipe, Lagarto 49060-110, Brazil
Genoile Oliveira Santana, Departamento Ciências da Vida, Universidade do Estado da Bahia, Salvador 41.150-000, Brazil
Author contributions: Lopes MB, Rocha R, Coqueiro FG, and Santana GO designed the research; Lopes MB, Coqueiro FG, and Lima CA performed the research; Lopes MB, Rocha R, and de Oliveira CC analyzed the data; Lopes MB, Lyra AC, Rocha R, and Santana GO wrote the paper.
Institutional review board statement: The Ethics Committee of the University Hospital Professor Edgar Santos approved the study protocol (nº117/2011).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at raquelrocha2@yahoo.com.br. Participants gave informed consent for data sharing. No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Raquel Rocha, DSc, MSc, Academic Research, Adjunct Associate Professor, Ciências da Nutrição, Universidade Federal da Bahia, Avenida Araújo Pinho, 32, Salvador 40110-060, Brazil. raquelrocha2@yahoo.com.br
Received: January 28, 2022
Peer-review started: January 28, 2022
First decision: March 10, 2022
Revised: April 27, 2022
Accepted: May 28, 2022
Article in press: May 28, 2022
Published online: July 5, 2022
Processing time: 153 Days and 7.8 Hours
ARTICLE HIGHLIGHTS
Research background

Inflammatory bowel disease is associated with complications such as low bone mineral density and increased risk of fracture compared to healthy controls. In patients with ulcerative colitis, the prevalence of osteoporosis varies between 2% to 9% and the main risk factors are related to genetics, chronic inflammatory status, treatment with steroids, and low weight.

Research motivation

There is little evidence that brings the relationship of nutritional risk factors with the development of reduced bone mineral density (BMD) in patients with ulcerative colitis, despite the studies demonstrating the relationship between nutritional risk factors and low BMD are more frequent in patients with Crohn’s disease, considering the extension and severity of factors the disease, which can compromise the main sites of nutrient absorption

Research objectives

To investigate the association of indicators of total body mass and body composition with BMD in patients with ulcerative colitis (UC).

Research methods

This is a cross-sectional study on adult UC patients of both genders who were followed on an outpatient basis. A control group consisting of healthy volunteers, family members, and close people was also included. The nutritional indicators evaluated were body mass index (BMI), total body mass (TBM), waist circumference (WC), body fat in kg (BFkg), BF in percentage (BF%), trunk body fat (TBF), and also lean mass. Body composition and BMD assessments were performed by dual-energy X-ray absorptiometry.

Research results

Most UC patients (97.0%) were in remission of the disease, 58.8% were eutrophic, 33.8% were overweight, 39.0% had high WC, and 67.6% had excess BF%. However, mean BMI, WC, BFkg, and TBF of UC patients were lower when compared to those of the control group (P < 0.05). Reduced BMD was present in 41.2% of patients with UC (38.2% with osteopenia and 2.9% with osteoporosis) and 3.0% in the control group (P < 0.001). UC patients with low BMD had lower BMI, TBM, and BFkg values than those with normal BMD (P < 0.05). Male patients were more likely to have low BMD (prevalence ratio [PR] = 1.86; 95% confidence interval [CI]: 1.07–3.26). Those with excess weight (PR = 0.43; 95%CI: 0.19-0.97) and high WC (PR = 0.44; 95%CI = 0.21-0.94) were less likely to have low BMD.

Research conclusions

Patients with UC in remission have a high prevalence of metabolic bone diseases and body fat appears to protect against the development of low BMD in these patients

Research perspectives

The future perspective is to evaluate other nutritional characteristics such as food consumption.