İNFLAMATUAR BARSAK HASTALIĞINDA OSTEOPOROZ VE VERTEBRA KIRIKLARI

Amac: Dunyada en sik gorulen metabolik kemik hastaligi olan osteoporoz (OP) Inflamatuar Barsak Hastaligi (IBH) olan hastalarda   yuksek oranda (%32 -77) gorulmektedir. IBH’ nda dusuk Kemik mineral yogunlugu (KMY) etyolojisinin multifaktoriyel oldugu dusunulmektedir. Bu calismada IBH olanlarda osteoporoz nedenlerini saptayarak; ulseratif kolit (UK) ve Crohn hasta- larini KMY acisindan karsilastirmak; her iki grupta vertebral kirik sikligini ve kirik varliginda sidde- tini saptamak hedeflenmistir. Gerec ve Yontemler: Calismamiza 2009 yilinda  Okmeydani Egitim ve Arastirma Hastanesi Gast- roenteroloji Kliniginden takipli 18 UK ve 33 CH dahil edildi.  Dual enerjili x-ray absorpsiyometrisi (DEXA) ile KMY olcumu ve Genant yontemi ile de vertebral kiriklar tespit edildi. Bulgular: Yas ortalamalari 43 olan her iki grupta VKI,hastalik yasi, tutulum yeri,steroid-kalsiyum/D vitamini alimi ile KMY arasi iliski saptanmadi. UK grubunda lomber vertebralarda %20- femur boynunda %4 osteoporoz; CH grubunda  %13-%7 oraninda osteoporoz saptandi. UK hastalarinin %68’inde, Crohn hastalarinin %48’inde kirik tespit edildi. Her iki grupta kirik olusumunda yas ve cinsiyet acisindan fark gorulmedi. KMY ile kirik olusumu arasinda da iliski mevcut degildi. Sonuc: IBH’nda osteoporoz (OP) patogenezi multifaktoriyeldir ve erken yasta OP olustugu icin onemli bir morbidite nedenidir. Anahtar Kelimeler: Inflamatuar Barsak Hastaliklari; Osteoporoz; Crohn Hastaligi SUMMARY Objective: Osteoporosis(OP) is the most common metabolic disease and seen higher in Inflama- tory bowel disease (IBD) (%32-77). The etyology  is thought as multifactorial. In this study we looked at the causes of OP in IBD. We compared bone mineral density (BMD) in ulserative colitis (UC) and crohn group (CD) and  determined the severity of vertebral fracture frequency. Mateials and Methods: 18 UC and 33 CD patients followed in  Okmeydani Egitim and Arastirma Hastanesi Gastroenterology Clinical in 2009. BMD measured by Dual-energy X-ray absorptiometry (DXA, DEXA) and vertebral fractures are fined with Genant method. R esults: Mean age was 43. No relation found between BMI, involvement in disease, disease age, using corticosteroid-calcium-D vitamins and BMD in both group. The patients in UC has   %20 osteoporosis in lumbal spines and %4 in femoral neck; patients in CD has  %13-%7 osteoporosis. There was %68 spine fracture in UC , %48 in CD. There were no differences between fracture and age - sex . No relation found between fracture formation and BMD. Conclusion: The pathogenesis of osteoporosis (OP) in IBH is multifactorial and an important cause of morbidity. K e y Words: Inflamatory Bowel Diseases; Osteoporosis; Crohn’s Disease