Bone health in inflammatory bowel disease

Expert Rev Gastroenterol Hepatol. 2023 Jul-Dec;17(9):921-935. doi: 10.1080/17474124.2023.2248874. Epub 2023 Aug 20.

Abstract

Introduction: Inflammatory bowel disease (IBD) is a chronic disease characterized by the presence of systemic inflammation, manifesting not only as gastrointestinal symptoms but also as extraintestinal bone complications, including osteopenia and osteoporosis. However, the association between IBD and osteoporosis is complex, and the presence of multifactorial participants in the development of osteoporosis is increasingly recognized. Unlike in adults, delayed puberty and growth hormone/insulin-like growth factor-1 axis abnormalities are essential risk factors for osteoporosis in pediatric patients with IBD.

Areas covered: This article reviews the potential pathophysiological mechanisms contributing to osteoporosis in adult and pediatric patients with IBD and provides evidence for effective prevention and treatment, focusing on pediatric patients with IBD. A search was performed from PubMed and Web of Science inception to February 2023 to identify articles on IBD, osteoporosis, pediatric, and fracture risk.

Expert opinion: A comprehensive treatment pattern based on individualized principles can be used to manage pediatric IBD-related osteoporosis.

Keywords: Fracture; inflammatory bowel disease; osteopenia; osteoporosis; pediatric.

Publication types

  • Review

MeSH terms

  • Adult
  • Bone Density
  • Bone Diseases, Metabolic* / diagnosis
  • Bone Diseases, Metabolic* / epidemiology
  • Bone Diseases, Metabolic* / etiology
  • Child
  • Humans
  • Inflammatory Bowel Diseases* / complications
  • Inflammatory Bowel Diseases* / diagnosis
  • Inflammatory Bowel Diseases* / epidemiology
  • Osteoporosis* / epidemiology
  • Osteoporosis* / etiology

Supplementary concepts

  • Juvenile osteoporosis