• Meta-analysis
• NLR
• Neutrophil to lymphocyte ratio
• Post-menopausal osteoporosis

• Humans
• Female
• Bone Density
• Neutrophils
• Postmenopause
• Osteoporosis/etiology
• Bone Diseases, Metabolic/complications
• Lymphocytes
• Osteoporosis, Postmenopausal

• Crohn's disease
• calcium
• diagnosis
• inflammation
• magnesium
• nutrition

• Adult
• Humans
• Crohn Disease/diagnosis
• Calcium
• Magnesium
• Nutritional Status
• Calcium, Dietary
• Inflammation

• arthritis
• cell trafficking
• cytokines
• gut–bone axis
• hormone and electrolyte metabolism
• inflammatory bowel disease
• intestinal dysbiosis
• intestinal microbiota
• osteoporosis
• spondyloarthropathy

• DFG MA 2621/5-1 Deutsche Forschungsgemeinschaft
• DFG CRC1181 - project C04 Deutsche Forschungsgemeinschaft

Inflammatory bowel disease (IBD) patients have a significant risk of developing bone loss. The trabecular bone score (TBS) is a relatively new parameter used to provide information on bone quality. The study cohort included 81 patients with IBD and 81 healthy controls. Blood tests, dual-energy x-ray absorptiometry (DXA), including TBS, were assessed. Harvey–Bradshaw Index (HBI) for Crohn's disease (CD) and the Partial Mayo Score for ulcerative colitis (UC) were used for evaluation of clinical disease activity. Compared with the healthy controls, the IBD patients had lower lumbar spine (LS) bone mineral density (BMD) (1.06 ± 0.18 vs. 1.16 ± 0.15 g/cm², p < 0.005), hip BMD (0.88 ± 0.13 vs. 0.97 ± 0.13 g/cm², p < 0.005) and TBS (1.38 ± 0.1 vs. 1.43 ± 0.1, p < 0.005) values. The patients with stricturing CD had lower TBS (1.32 ± 0.13 vs. 1.40 ± 0.9, p = 0.03) and LS BMD (0.92 ± 0.19 vs. 1.07 ± 0.1, p = 0.01) values compared with those with non-stricturing CD. Multivariate regression model analysis identified HBI as independent factor associated with TBS. Our results support that all DXA parameters are lower in patients with IBD than in healthy patients. Moreover, TBS is a valuable tool for assessment of bone impairment in active CD.

• Bone mineral density
• Hypocitraturia
• Idiopathic hypercalciuria
• Lithogenic risk

• Combination therapy
• Glucocorticoid
• Nanocochleate
• Osteoporosis
• Phosphatidylserine

Decreased bone mass in patients with inflammatory bowel diseases (IBD) is a clinical problem with extremely severe consequences of osteoporotic fractures. Despite its increasing prevalence and the need for mandatory intervention and monitoring, it is often ignored in IBD patients’ care. Determining the biomarkers of susceptibility to bone mineral density disorder in IBD patients appears to be indispensable. We aim to investigate the impact of estrogen receptor gene (ESR1) gene polymorphisms on bone mineral density (BMD) in patients with ulcerative colitis (UC) and Crohn’s disease (CD), as they may contribute both, to osteoporosis and inflammatory processes. We characterised 197 patients with IBD (97 with UC, 100 with CD), and 41 controls carrying out vitamin D, calcium and phosphorus serum levels, and bone mineral density assessment at the lumbar spine and the femoral neck by dual-energy X-ray absorptiometry (DXA), ESR1 genotyping and haplotype analysis. We observed that women with CD showed the lowest bone density parameters, which corresponded to the ESR1 c.454-397T and c.454-351A allele dose. The ESR1 gene PvuII and XbaI TA (px) haplotype correlated with decreased femoral neck T-score (OR = 2.75, CI = [1.21–6.27], P-value = 0.016) and may be predictive of osteoporosis in female patients with CD.

• ESR1 gene polymorphism
• bone mineral density
• osteoporosis in the course of inflammatory bowel diseases

• Crohn’s disease
• dual energy X-ray absorptiometry
• inflammatory bowel disease
• osteopenia
• osteoporosis
• steroids
• ulcerative colitis

We performed a scoping review on sought-after complementary therapies for patients with inflammatory bowel disease (IBD), specifically diet, physical activity and exercise (PA/E), and psychotherapy. We aim to update patients with IBD on therapies for self-care and provide physicians with guidance on how to direct their patients for the management of IBD. A search of MEDLINE, EMBASE, and PUBMED was completed in Sept 2016. Studies on diet, PA/E, or psychotherapy in patients with IBD were included. Medical Subject Heading terms and Boolean operators were used. The search was limited to full-text English articles describing an adult population. This review included 67 studies: Diet (n = 19); PA/E (n = 19); and psychotherapy (n = 29). We have made the following recommendations: (1) Diet: Consumption of diets rich in vegetables, fruit and soluble fiber may be beneficial in IBD. A trial of a low FODMAP diet can be considered in those patients with functional gastrointestinal symptoms. Restrictive diets are lacking in evidence and should be avoided; (2) PA/E: Regular low-moderate intensity activity, including cardiovascular and resistance exercise, has been shown to improve quality of life (QOL) and may improve inflammation; and (3) psychotherapy: Therapies such as cognitive-behavioural interventions, mindfulness, hypnosis, and stress management have been shown to improve QOL, but evidence is limited on their impact on anxiety, depression, and disease activity. Overall, these complementary therapies are promising and should be used to treat patients with IBD from a more holistic perspective.

• Scoping review
• Inflammatory bowel disease
• Diet
• Exercise
• Psychotherapy

• Complementary Therapies/methods
• Complementary Therapies/standards
• Dietary Fiber/therapeutic use
• Gastroenterology/methods
• Gastroenterology/standards
• Humans
• Inflammatory Bowel Diseases/therapy
• Physical Therapy Modalities/standards
• Practice Guidelines as Topic
• Psychotherapy/methods
• Psychotherapy/standards
• Quality of Life
• Self Care/methods

Bone mineral density (BMD) is often low in patients with Crohn's disease (CD). This study aimed to evaluate the association between nutritional factors and BMD in a group of CD patients.

CD patients 18 years of age or older were included. The body mass index (BMI), waist circumference (WC) and dietary intake were evaluated during two 24-hour recalls. Bone densitometry was performed by dual-energy X-ray absorptiometry of the full body to assess body composition and of the lumbar vertebrae and femoral neck to assess BMD.

In the 60 patients evaluated, there was no association between BMD and disease activity or between BMD and disease duration. We observed moderate correlations between BMD in at least one of the evaluated sites and BMI, lean mass, WC, and protein, calcium, phosphorus and magnesium dietary intakes (P<0.05). In the linear regression analysis for spinal BMD, only BMI and calcium dietary intake remained associated (P<0.05). In the linear regression analysis for femoral BMD, WC and phosphorus intake continued to be significant in the final model, although they had low explanatory power for BMD (P<0.05).

The prevalence of low BMD was high in CD patients. BMI, WC, calcium and phosphorus dietary intake were positively correlated with BMD.

• Body mass index
• Bone density
• Crohn disease
• Nutritional features
• Waist circumference

• Breastfeeding
• Inflammatory bowel disease
• Pregnancy
• Vaccines
• Women

Inflammatory bowel disease (IBD) is associated with low bone mineral density (BMD). In this study, the association between disease severity and BMD in patients with IBD was evaluated. Associations between BMD and the Montreal classification, disease activity and drug therapy were also tested. A cross-sectional prevalence study with a comparison group was conducted. One hundred and twenty-eight patients were evaluated: 68 patients with ulcerative colitis (UC), and 60 with Crohn's disease (CD). The control group consisted of 67 healthy subjects. All patients and controls had BMD measured and in IBD patients, current medications, hospitalization, and disease location, extent and phenotype, according to the Montreal classification, were recorded. Multiple correspondence analysis was applied to evaluate categorical variables. In the CD group, most patients were diagnosed between 17–40 years of age. Ileocolonic and non-stricturing non-penetrating disease were the most frequent disease location and behavior, respectively. In UC patients, extensive colitis was the most frequent disease location. UC and CD patients were more likely to have osteopenia than controls (OR=14.93/OR=24.38, respectively). In the CD group, male patients, perianal disease, penetrating behavior and age at diagnosis >40 years were associated with low BMD. Taking azathioprine and infliximab also seemed to be associated with osteopenia. In the UC group, we observed an association between low BMD and male patients, left colitis, corticosteroid use and hospitalization. Disease activity was not associated with osteopenia or osteoporosis in CD and UC patients. Disease severity seems to be associated with osteopenia in IBD patients.

• Arthritis
• LRP5
• Osteogenesis Imperfecta
• Osteoporosis Pseudoglioma syndrome
• Sclerostin

• Animals
• Antibodies/therapeutic use
• Bone Density
• Bone Diseases/drug therapy
• Bone Diseases/physiopathology
• Bone Morphogenetic Proteins/immunology
• Disease Models, Animal
• Humans
• Osteoporosis/drug therapy
• Osteoporosis/physiopathology

• K08 AR063813 NIAMS NIH HHS

• older
• inflammatory bowel disease
• crohn’s disease
• ulcerative colitis

Inflammatory bowel disease (IBD) patients exhibit higher risk for bone loss than the general population. The chronic inflammation causes a reduction in bone mineral density (BMD), which leads to osteopenia and osteoporosis. This article reviewed each risk factor for osteoporosis in IBD patients. Inflammation is one of the factors that contribute to osteoporosis in IBD patients, and the main system that is involved in bone loss is likely RANK/RANKL/osteoprotegerin. Smoking is a risk factor for bone loss and fractures, and many mechanisms have been proposed to explain this loss. Body composition also interferes in bone metabolism and increasing muscle mass may positively affect BMD. IBD patients frequently use corticosteroids, which stimulates osteoclastogenesis. IBD patients are also associated with vitamin D deficiency, which contributes to bone loss. However, infliximab therapy is associated with improvements in bone metabolism, but it is not clear whether the effects are because of inflammation improvement or infliximab use. Ulcerative colitis patients with proctocolectomy and ileal pouches and Crohn’s disease patients with ostomy are also at risk for bone loss, and these patients should be closely monitored.

• Bone mineral density
• Crohn’s disease
• Osteoporosis
• Ulcerative colitis
• Inflammatory bowel disease
• Risk factors

Vitamin D deficiency has been recognized as an environmental risk factor for Crohn's disease since the early 80s. Initially, this finding was correlated with metabolic bone disease. Low serum 25-hydroxyvitamin D levels have been repeatedly reported in inflammatory bowel diseases together with a relationship between vitamin D status and disease activity. Subsequently, low serum vitamin D levels have been reported in various immune-related diseases pointing to an immunoregulatory role. Indeed, vitamin D and its receptor (VDR) are known to interact with different players of the immune homeostasis by controlling cell proliferation, antigen receptor signalling, and intestinal barrier function. Moreover, 1,25-dihydroxyvitamin D is implicated in NOD2-mediated expression of defensin-β2, the latter known to play a crucial role in the pathogenesis of Crohn's disease (IBD1 gene), and several genetic variants of the vitamin D receptor have been identified as Crohn's disease candidate susceptibility genes. From animal models we have learned that deletion of the VDR gene was associated with a more severe disease. There is a growing body of evidence concerning the therapeutic role of vitamin D/synthetic vitamin D receptor agonists in clinical and experimental models of inflammatory bowel disease far beyond the role of calcium homeostasis and bone metabolism.

• Body mass index
• Crohn's disease
• Inflammatory bowel disease
• Japanese
• Osteoporosis
• Ulcerative colitis

• Crohn's disease
• Immunosuppressive therapy
• Osteoporosis
• Ulcerative colitis

• Absorptiometry, Photon
• Adalimumab
• Adult
• Aged
• Anti-Inflammatory Agents/therapeutic use
• Antibodies, Monoclonal/therapeutic use
• Antibodies, Monoclonal, Humanized/therapeutic use
• Azathioprine/therapeutic use
• Bone Density
• Bone Density Conservation Agents/administration & dosage
• Bone Diseases, Metabolic/etiology
• Bone Diseases, Metabolic/prevention & control
• Calcium, Dietary/administration & dosage
• Cohort Studies
• Drug Therapy, Combination
• Female
• Femur/diagnostic imaging
• Glucocorticoids/therapeutic use
• Humans
• Immunosuppressive Agents/therapeutic use
• Inflammatory Bowel Diseases/complications
• Inflammatory Bowel Diseases/drug therapy
• Infliximab
• Lumbar Vertebrae/diagnostic imaging
• Male
• Mesalamine/therapeutic use
• Middle Aged
• Osteoporosis/etiology
• Osteoporosis/prevention & control
• Tumor Necrosis Factor-alpha/antagonists & inhibitors
• Vitamin D/administration & dosage
• Young Adult

• immunoregulation
• inflammation
• inflammatory bowel disease
• treatment
• vitamin D

• Adolescent
• Adrenal Cortex Hormones/adverse effects
• Adult
• Aged
• Bone Density
• Bone Diseases, Metabolic/etiology
• Cross-Sectional Studies
• Female
• Humans
• Inflammatory Bowel Diseases/complications
• Inflammatory Bowel Diseases/drug therapy
• Inflammatory Bowel Diseases/physiopathology
• Male
• Middle Aged
• Prospective Studies
• Risk Factors
• Vitamin D Deficiency/complications
• Young Adult

• Crohn's disease
• bone mineral density
• inflammatory bowel disease
• ulcerative colitis
• vitamin D

• bone mineral density
• inflammatory bowel disease
• osteopenia
• osteoporosis
• saudi