Ülseratif kolit hastalığı kemik mineral yoğunluğunu etkiler mi?

Yıl 2018, Cilt: 5 Sayı: 3, 145 - 150, 28.09.2018

Tahir Buran

Öz

Ülseratif kolit hastalığı kemik mineral yoğunluğunu etkiler mi?

Öz

Giriş:  İnflamatuvar barsak hastalığı(İBH) olan hastalarda kemik mineral
kaybı(KMK) normal popülasyon ile karşılaştırıldığında daha yüksek (%32 -77)
görülmektedir. İBH‘lı hastalarda düşük kemik yoğunluğu hem erkek hem kadınlarda
görülmekte ve erken yaşlarda ortaya çıkabilmektedir. Ayrıca kortikosteroid
kullanımı KMK nedeni olabilmektedir.

Amaç: Ülseratif Kolitli(ÜK) hastalarda
osteopeni ve osteoporoz sıklığını, hastalık yaşı, hastalık tutulum yeri,
hastalık aktivitesi, cinsiyet ve steroid kullanımı ile osteopeni ve osteoporoz
arasında ilişki olup olmadığını tesbit etmeyi amaçladık.

Materyel ve Metod: Çalışmamıza Ocak 2014 ile şubat 2018
tarihleri arasında Manisa Celal Bayar üniversitesi Tıp Fakültesi
Gastroenteroloji Kliniğine başvuran ve tarafımızdan takip edilen  15’i erkek, 21’i kadın toplam 36 ÜK hastası
alındı. Bu hastaların Kemik mineral yoğunluğu(KMY) DEXA cihazı ile ölçüldü,
retrospektif olarak kayıtları incelendi.

 Hastalık tanısı klinik bulgular, kolonoskopi
ve histopatoloji ile konuldu.

 Tüm hastalara DEXA DPX-PRO(GE-LUNAR DPX-NT)
ile APspine(vertebra) ve femur boynu kemik mineral dansitometre ölçümü yapıldı.
T skor değerleri >-1 normal, -1>T>-2.5 osteopeni, T<-2,5 değerler
osteoporoz olarak değerlendirildi.

Hastalar; klinik
aktivite, tutulum yeri, cinsiyet, steroid kullanımı, hastalık yaşı açısından
değerlendirildi. Tüm hastaların KMY ölçülerek 
bu parametreler ile ilişkileri araştırıldı.

Bulgular: Çalışmaya alınan erkek hastaların yaş
ortalamaları :46.66,  kadın hastaların
yaş ortalaması :46.52 idı. Erkeklerin 7’sinde(%46.6), kadınların 10’unda(%47.6)
osteopeni tesbit edildi. Ayrıca 1 erkek hastada(%3) ve 2 kadın hastada(%9.5)
osteoporoz saptandı, hiçbir hastada kemik kırığı yoktu.

Osteopoz
tanısı konulan 3 hastanın 1’inde( %33) Pankolit, 2’sinde (%66) proktitis
mevcuttu. Osteopeni tesbit edilen 17 hastanın  6’sında(%35,3) pankolit, 10’unda(%58.8)
proktit mevcuttu.

Aktif  ÜK  olan 33 hastanın 20’sinde(%60.6 KMK (17’si
osteopeni, 3’ü osteoporoz) tesbit edildi, 13’ünde(%39.4) ise KMK yoktu. İnaktif
koliti olan 3 hastanın  birinde KMK
tesbit edildi,

Sonuç: Kadınlarda aktif ÜK de  KMK daha fazlaydı. Ayrıca Aktif ÜK’i olan
hastaların %55.55’sında kemik mineral bozukluğu mevcut olup hastalık aktivitesi
ile KMK arasında pozitif ilişki tesbit edilmedi. Kolon tutulum yeri ile KMK
arasında fark yoktu . Ayrıca Kortikosteroid kullanımı ile KMK arasında ise pozitif
bir ilişki bulunamadı.

Anahtar Kelimeler: Ülseratif
Kolit, Osteoporoz, osteopeni, kemik mineral dansitesi

 

Does Ulcerative Colitis
Affect Bone Mineral Density?

 

Aim: The aim of this study was to
determine the frequency of osteopenia and osteoporosis in ulcerative colitis
(UC) patients and the relationship between disease age, disease incidence,
disease activity, sex and steroid use, osteopenia and osteoporosis.

Materials and Methods: 36 patients (15 men and 21 women
with ulcerative colitis) who were admitted to the Gastroenterology Clinic of
Manisa Celal Bayar University Faculty of Medicine between January 2014 and
February 2018 and whose bone mineral density was measured (DEXA) were included
in the study. retrospectively reviewed their records.

Patients;
Clinical activity was assessed in terms of location, sex, steroid use, and age
of the disease. Bone mineral density of all patients was measured and their
relationship with these parameters was investigated.

Findings: A total of 36 patients with
ulcerative colitis who were measured bone mineral density were included in the
study. 15 of these patients were male (mean age: 46.66) and 21 were female
(mean age: 46.52). Osteopenia was detected in 7 (46.6%) of the males and 10
(47.6%) of the females. In addition, osteoporosis was detected in 1 male
patient (3%) and 2 female patients (9.5%) and no bone fracture was observed in
any patient.

Bone mineral
deficiency (17% osteopenia, 3 osteoporosis) was detected in 20 of 33 patients
with active ulcerative colitis (60.6%) and bone mineral loss (BMD) was absent
in 13 patients (39.4%). bone mineral loss was detected in one, not in two.

Conclusion: Female ulcerative colitis bone
mineral loss was greater in women. In addition, bone mineral deficiency was
found in 55.55% of patients with active ulcerative colitis and there wasn’t a
positive relationship between disease activity and BMD. There was also no
positive correlation between corticosteroid use and BMD.

Keywords: Ulcerative colitis, Osteoporosis,
osteopenia, bone mineral density

Anahtar Kelimeler

ülseratif kolit, kemik mineral yoğunluğu

Kaynakça

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