The Relationship Between Inflammatory Bowel Disease and Bone Mineral Density. Results of a Population-based Study
Bibliographic record
Abstract
Purpose: Patients with inflammatory bowel disease (IBD) are at higher risk of osteoporosis and related fractures. Most studies on IBD and BMD are from selected referral centres and do not delineate what aspects of IBD contribute to lower BMD. Methods: We created a linkage between the University of Manitoba IBD Epidemiologic Database and the Manitoba BMD Database, which respectively capture virtually all persons in Manitoba, Canada with diagnosed IBD and all persons with clinical DXA measurements, respectively. BMD was assessed at each of the lumbar spine (L1-L4), total hip, femoral neck and greater trochanter. Multivariate linear and logistic regression were performed to determine the independent effect of an IBD diagnosis on T-scores and on the likelihood of having an osteoporotic T-score (-2.5 or lower) at each of the four BMD sites. We developed both a partially adjusted model (for age, sex, and body mass index [BMI]) and fully adjusted model (additionally adjusted for hormone replacement therapy [HRT], osteoprotective therapy [OTX], and recent systemic glucocorticoid [GC] use). Results: 45,714 patients age 20 and older underwent baseline BMD testing between 1997 and 2008, 1,230 of whom had IBD. Compared with non-IBD subjects, subjects with IBD were more likely to be younger, male, and have lower BMI. IBD patients were significantly more likely to be recent GC users (26% vs 6%). When adjusted for age, sex and BMI, IBD was associated with lower T-scores at each of the four assessment sites (Table 1). IBD was also associated with having an osteoporotic T-score at the L1-L4 and the total hip (Table 1). However, when the model was further adjusted for exposure to GCs, HRT, and OTX, IBD was associated with only a marginal reduction in T-scores at the total and the greater trochanter. Moreover, IBD was not associated with a higher risk of having an osteoporotic T-score at any of the four sites in the fully adjusted model. Conclusion: While patients with IBD are at higher risk for lower BMD and for osteoporosis, this effect is not seen after adjusting for exposure to GCs and other medications. This suggests that the deleterious effects of IBD on BMD are predominantly related to GCs rather than to the IBD itself. Further work is required to delineate the independent effects of IBD, inflammatory activity, and its therapies on BMD and fracture risk.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".