CAJ | 학술논문

目的对炎症性肠病(IBD)患者的骨密度状况进行评估,探讨其下降的危险因素.方法通过对IBD患者血液学指标、身高、体重及腰椎骨密度进行测量,并与健康志愿者比较,分析IBD患者骨质疏松的危险因素.结果共收集克罗恩病(CD)77例,溃疡性结肠炎(UC)43例,37例健康志愿者作为对照组.CD组、UC组及对照组的腰椎骨质的T值分别为-1.72±1.20、-1.26±1.12和-0.62±0.87,CD组的T值低于UC组(P=0.045)和对照组(P=0.000),UC组T值低于对照组(P=0.014).CD组、UC组及对照组的腰椎骨质疏松的发生率分别为23.3%、14.0%和0;CD组的腰椎骨质疏松发生率高于对照组,差异有统计学意义(P=0.003);UC组的腰椎骨质疏松发生率有高于对照组的趋势,但差异无统计学意义(P=0.053).多元回归分析显示,低体重(BMI≤18.4kg/m~2)是CD(OR=11.25,95%CI 3.198～39.580,P=0.000)和UC(OR=14.50,95%CI 1.058～88.200,P=0.045)患者骨质疏松的危险因素.年龄、病程、病变部位、CD活动指数(CDAI)、服用糖皮质激素、服用免疫抑制剂、血清25-羟基维生素D浓度等因素与骨质疏松的发生无相关性.结论骨密度下降的发生在IBD患者中较为普遍,低体重是IBD患者骨质丢失的危险因素.
목적 대염증성장병(IBD)환자적골밀도상황진행평고,탐토기하강적위험인소.방법 통과대IBD환자혈액학지표、신고、체중급요추골밀도진행측량,병여건강지원자비교,분석IBD환자골질소송적위험인소.결과 공수집극라은병(CD)77례,궤양성결장염(UC)43례,37례건강지원자작위대조조.CD조、UC조급대조조적요추골질적T치분별위-1.72±1.20、-1.26±1.12화-0.62±0.87,CD조적T치저우UC조(P=0.045)화대조조(P=0.000),UC조T치저우대조조(P=0.014).CD조、UC조급대조조적요추골질소송적발생솔분별위23.3%、14.0%화0;CD조적요추골질소송발생솔고우대조조,차이유통계학의의(P=0.003);UC조적요추골질소송발생솔유고우대조조적추세,단차이무통계학의의(P=0.053).다원회귀분석현시,저체중(BMI≤18.4kg/m~2)시CD(OR=11.25,95%CI 3.198～39.580,P=0.000)화UC(OR=14.50,95%CI 1.058～88.200,P=0.045)환자골질소송적위험인소.년령、병정、병변부위、CD활동지수(CDAI)、복용당피질격소、복용면역억제제、혈청25-간기유생소D농도등인소여골질소송적발생무상관성.결론 골밀도하강적발생재IBD환자중교위보편,저체중시IBD환자골질주실적위험인소.
Objective To evaluate the prevalence of low bone mineral density in patients with inflammatory bowel disease(IBD) and to identify its risk factors. Methods A cross-sectional survey was carried out in IBD patients. Anthropemetric measures, biochemical markers of nutrition and bone mineral density measurement were completed for these patients as well as healthy control subjects. Results Seventy-seven Crohn's disease (CD) and 43 ulcerative colitis(UC) patients were enrolled, and 37 healthy volunteers were recruited as healthy controls(HC). The T value of CD patients, UC patients and HC was -1.72±1.20,-1.26±1.12 and-0.62±0.87 respectively and the T value of CD patients was significantly lower than that of HC (P=0.000). The prevelance of osteoporosis in CD, UC and HC was 23.3%, 14.0% and 0 respectively. The prevelance of osteoporosis in CD was higher than that in HC (P=0.003). Logistic regression analysis indicated that low BMI(BMI≤18.4 kg/m~2) was an independent risk factor for osteoporosis both in CD (OR=11.25,95% CI 3.198-39.580, P=0.000) and in UC (OR= 14. 50,95% CI 1.058-88.200, P=0.045) patients. Age, disease duration, clinical activity active index (CDAI), oral steroid therapy, immunosuppressant treatment and serum vitamin D concentration were not found to be correlated with osteoperosis in IBD patients. Conclusions Low bone mineral density is common in both CD and UC patients and low BMI is an independent risk factor for osteoporosis in IBD patients.