Osteoporosis is a common occurrence in patients with Crohn's disease. However, relatively little is known about the risk of actual fractures in these patients.
Therefore, researchers from the Mayo Clinic and Foundation in Rochester, Minnesota, USA, examined the medical records of Crohn's patients in Olmsted County, Minnesota.
The notes of all 283 residents within the county who had been diagnosed with Crohn's disease between 1940 and 1993 were reviewed for evidence of subsequent fractures and compared with a control group of county residents matched by age and sex.
The risk ratio of fracture in patients relative to controls was then estimated using the Cox proportional hazards regression model.
The cumulative incidence of fracture following diagnosis was estimated using the Kaplan-Meier method.
The researchers identified 63 patients with 117 different fractures.
| Surgical resection - not a predictor of fracture risk |
The cumulative incidence of any fracture from the time of diagnosis onward was 36% at 20 years versus 32% in controls.
Compared with controls, the overall risk ratio for any fracture was
0.9 (95% CI, 0.6-1.4), while the relative risk for an osteoporotic fracture
was 1.4 (95% CI, 0.9-5.5).
In the case of a thoracolumbar vertebral fracture, the risk ratio was
2.2 (95% CI, 0.9-5.5).
Only age was found to be a significant clinical predictor of fracture risk (hazard ratio per 10-year increase in age, 1.3; 95% CI, 1.1-1.5), as identified by Cox proportional hazards regression.
Specifically, use of corticosteroids and surgical resection did not predict risk of fracture among these unselected patients with Crohn's disease.
Concluding, Dr Edward V. Loftus Jr, one of the report authors said, according to their study, "the risk of fracture was not elevated relative to age- and sex-matched controls."