Microscopic Colitis Is Not an Independent Risk Factor for Low Bone Density
- PDF / 686,376 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 106 Downloads / 191 Views
ORIGINAL ARTICLE
Microscopic Colitis Is Not an Independent Risk Factor for Low Bone Density Elliot J. Graziano1 · Byron P. Vaughn2 · Qi Wang3 · Lisa S. Chow4 · James P. Campbell5 Received: 29 June 2020 / Accepted: 1 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Microscopic colitis (MC) is a subtype of inflammatory bowel disease (IBD) with overlapping risk factors for low bone density (LBD). While LBD is a known complication of IBD, its association with MC is not well-established. Aims Assess the prevalence of LBD in MC compared to control populations, and evaluate if MC predicts LBD when controlling for confounders. Methods Retrospective, observational case control study of adult patients with pathologically confirmed MC from 2005 to 2015. Bone density measurements were abstracted from dual-energy X-ray absorptiometry (DEXA) reports, and bone density was classified using T-score: normal (T ≥ − 1.0), osteopenia (− 1.0 > T > -2.5) or osteoporosis (T ≤ − 2.5). Demographics, disease, medication history and LBD risk factors were obtained from chart review. Prevalence of LBD was compared to national and local controls. A matched control cohort to MC patients without prior diagnosis of LBD was analyzed with logistic regression to assess the relationship of MC to LBD. Results One hundred and eighteen patients with MC were identified. Osteopenia in women with MC was more prevalent compared to national controls (67% vs. 49%, p = 0.0004), and LBD was more prevalent in MC patients compared to local controls (82% vs. 55%, p T > − 2.5) or osteoporosis (T ≤ − 2.5). In the event that the T-score was not valid (determined from DEXA report), the Z-score was recorded and the DEXA report was manually reviewed for interpretation of bone mineral density. Assessment of Microscopic Colitis Diagnosis of MC was based upon review of available colonic biopsies reports. Lymphocytic colitis is defined as > 20 intraepithelial lymphocytes per 100 epithelial cells with a mixture of active and chronic inflammation involving the lamina propria [15], [16]. Collagenous colitis is defined as a collagen band of the sub epithelium (> 10 µm) as well as inflammatory involvement of the lamina propria [15, 16] Assessment of Covariates MC patient records and matched controls were manually reviewed for demographic data, relevant social history (smoking, alcohol use), medication history (including PPIs, steroids, supplemental estrogen use, surgical history (hysterectomy, bilateral oophorectomy), supplemental calcium and vitamin D use), associated diagnoses (thyroid disease, hyperparathyroidism, end stage renal disease) and DEXA
Digestive Diseases and Sciences
report. Alcohol and tobacco use was obtained from social history within the electronic medical record (EMR). Smoking status was qualified as current, former or never. Patient was considered a current smoker if use occurred at the time of DEXA. Any reported alcohol use prior to the DEXA was considered as an exposure; however alcohol use wa
Data Loading...
