Low body mass not vitamin d receptor polymorphisms predict osteoporosis in patients with inflammatory bowel disease

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To cite this article: C. L. NOBLE, J. MCCULLOUGH, W. HO, C. W. LEES, E. NIMMO, H. DRUMMOND, S. BEAR, J. HANNAN, C. MILLAR, S. RALSTON, J. SATSANGI Low body mass not vitamin d receptor polymorphisms predict osteoporosis in patients with inflammatory bowel disease Alimentary Pharmacology & Therapeutics (OnlineAccepted Articles). doi:10.1111/j.1365-2036.2008.03599.x

Low body mass not vitamin d receptor polymorphisms predict osteoporosis in patients with inflammatory bowel disease

C. L. NOBLE11Gastrointestinal Unit, J. MCCULLOUGH11Gastrointestinal Unit, W. HO11Gastrointestinal Unit, C. W. LEES11Gastrointestinal Unit, E. NIMMO11Gastrointestinal Unit, H. DRUMMOND11Gastrointestinal Unit, S. BEAR22Rheumatology Unit, Molecular Medicine Centre, University of Edinburgh, Western General Hospital, Edinburgh, J. HANNAN33Medical Physics Department, Western General Hospital, Edinburgh., C. MILLAR33Medical Physics Department, Western General Hospital, Edinburgh., S. RALSTON22Rheumatology Unit, Molecular Medicine Centre, University of Edinburgh, Western General Hospital, Edinburgh & J. SATSANGI11Gastrointestinal Unit.

1Gastrointestinal Unit, 2Rheumatology Unit, Molecular Medicine Centre, University of Edinburgh, Western General Hospital, Edinburgh, 3Medical Physics Department, Western General Hospital, Edinburgh.

Corresponding author: Dr Colin Noble MRCPGastrointestinal UnitMolecular Medicine CentreWestern General HospitalEdinburghEH4 2XUTel: 0Fax: 0E mail: noblecolin@...

Abstract

Background: Osteoporosis is a recognised complication of inflammatory bowel disease (IBD).

Aim: To investigate the role of environmental factors and Vitamin D receptor (VDR) variants on the prevalence of osteoporosis.

Methods: DEXA scans and case note review were performed on 440 IBD patients from 1997-2006. All the IBD patients and 240 healthy controls (HC) were genotyped for VDR variants Taq-1 and Apa-1 using PCR-RFLP.

Results: Osteoporosis and osteopenia rates were 15% and 18% for IBD, 16% and 18% for CD and 13% and 19% for UC respectively. On univariate analysis of the CD patients, low BMI (<18.5) and smoking status (p= 0.008 and 0.005 respectively) were associated with osteoporosis and osteopenia. Low BMI was also associated with osteoporosis on multivariate analysis in CD (p=0.021, OR=5.83, CI=1.31-25.94). No difference was observed between Taq-1 and Apa-1 VDR polymorphisms in IBD, CD, UC and HC. However, CD males were more likely to carry the mutant Taq-1 allele than HC males (p=0.0018, OR1.94, CI 1.28-2.92) and female CD patients (p=0.0061, OR 1.60, CI 1.17-2.44).

Conclusions: In this well phenotyped cohort of IBD patients, relatively low prevalence of osteoporosis were observed. Low BMI was the only independent risk factor identified to be associated with osteoporosis.