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. 2019 Sep 30;11(9):e5810.
doi: 10.7759/cureus.5810.

Inflammatory Bowel Disease and Risk of Osteoporotic Fractures: A Meta-Analysis

Diego F Hidalgo  1 , Boonphiphop Boonpheng  2 , Jennifer Phemister  3 , Jessica Hidalgo  4 , Mark Young  3
Affiliations

Inflammatory Bowel Disease and Risk of Osteoporotic Fractures: A Meta-Analysis

Diego F Hidalgo et al. Cureus. .

Abstract

Introduction Inflammatory bowel disease (IBD) and its complications have been well-established. The literature shows an association between IBD and decreased bone mineral density in the adult population. However, most studies have reported an association between IBD and osteoporosis, while the risk of fractures has not been well-studied. The aim of this meta-analysis is to summarize the best available evidence regarding IBS and osteoporotic fractures. Methods A review of the literature using the MEDLINE and EMBASE databases was performed during November 2017. We included cross-sectional and cohort studies that reported the relative risks, odds ratios, and hazard ratios comparing the risk of developing osteoporotic fractures among patients with IBD patients, both ulcerative colitis (UC) and Crohn's disease (CD), versus patients without IBD as controls. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using the generic inverse-variance method. Results After a review of the literature, seven studies fulfilled the eligibility criteria established during the analysis. A significant association was found between IBD and osteoporosis, with a pooled OR of 1.32 (95% CI, 1.2 - 1.4). Low heterogeneity among the studies was found, I2=42.3. No publication bias was found using the Egger regression test p=0.18. Sensitivity analysis showed that the inclusion of data on children by Kappelman et al. (2007) did not change the results. Conclusion A significant association between IBD and the risk of developing osteoporotic fractures was observed in this study. There is a 32% increased risk, which is consistent with different cohort studies previously done.

Keywords: bone mineral density; crohns disease; inflammatory bowel disease (ibd); malabsorption; osteoporosis; osteoporotic fractures; ulcerative colitis.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Newcastle-Ottawa quality assessment scale
Adapted from "The Ottawa Hospital, Research Center," by Wells G, Shea B. 2014, http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
Figure 2
Figure 2. Search criteria and eligibility
Figure 3
Figure 3. Relative risk and P values
Figure 4
Figure 4. Publication bias; Funnel plot
See this image and copyright information in PMC

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