《骨质疏松症与胃肠道疾病实践指南》内容预览：

Professor Alan B.R. Thomson University of Alberta, Canada
Dr. K. Siminoski, University of Alberta, Canada
Professor Michael Fried, University Hospital Zurich, Switzerland
Dr Roques Saenz, University del Desarrollo, Chile
Professor Henry Cohen, Clinica de Endoscopia y Gastroenterologia, Uruguay
Professor A. Elewaut, Gent University Hospital, Belgium
Professor Ole Thomsen, University of Copenhagen, Denmark
Drs. Justus Krabshuis, Highland Data, France

Some simple facts:
Peak bone mass is achieved by 30 years
After skeletal maturity, bone is lost at a rate of 0.5 - 1.0% per year
Women experience a phase of accelerated bone loss for 3-5 years after menopause
When bone density falls with age, fracture risk increases
The incidence of osteoporotic fracture increases dramatically with age, markedly so after the age of 60

Seriousness of osteoporotic hip fractures:
80% occur in women > 65 years
mortality rate is increased by approximately 24% in the year following the fracture
the risk of death associated with hip fracture is similar to that of breast cancer - for both the risk grows with age.
vertebral fractures are of concern in Crohn's patients, and are associated with impaired quality of life, chronic pain, impaired ability to carry out activities of daily living, social isolation, increased hospital drugs, and increased mortality

Prevalence of reduced bone mineral density (BMD) in Crohn's Disease (CD) and chronic ulcerative colitis (UC) vary widely, but affect about 25% of CD and UC patients (3,4,5,6)
Use of glucocorticosteroids (GCS) plays an important role (7,8)
Low BMD is clinically relevant, since there is a 40% increase in fracture incidence in patients with IBD (9)
Bone loss 3% per year in IBD without, and 6% with use of GCS (equal risk in males and females)
30-50% of chronic GCS users have fractures
Prevalence and extent of osteopenia / osteoporosis in UC less than in CD
Increased bone turnover (6)
Unlike CD, in UC osteoporosis is not usually present at the time of diagnosis and is mostly seen in steroid users

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