Comparison of fracture risk between patients with ileal pouch-anal anastomosis for ulcerative colitis and the general population
| Autor: | Søren Brandsborg, Anders Mark Christensen, Søren Laurberg, Peter Vestergaard |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Denmark medicine.medical_treatment Population Colonic Pouches Kaplan-Meier Estimate Anastomosis Risk Assessment Gastroenterology Bone and Bones Phosphates Bone remodeling Young Adult Internal medicine Prevalence medicine Humans Vitamin D Prospective cohort study education Retrospective Studies education.field_of_study Proctocolectomy business.industry Proctocolectomy Restorative Hazard ratio Retrospective cohort study General Medicine Middle Aged Alkaline Phosphatase Wrist Injuries Alcoholism Parathyroid Hormone Case-Control Studies Spinal Fractures Calcium Colitis Ulcerative Female Pouch business Osteoporotic Fractures |
| Zdroj: | Christensen, A M, Brandsborg, S, Vestergaard, P & Laurberg, S 2014, ' Comparison of fracture risk between patients with ileal pouch-anal anastomosis for ulcerative colitis and the general population ', Journal of Crohn's & colitis, vol. 8, no. 2, pp. 107-112 . https://doi.org/10.1016/j.crohns.2013.07.001 Christensen, A M, Brandsborg, S, Vestergaard, P & Laurberg, S 2014, ' Comparison of fracture risk between patients with ileal pouch-anal anastomosis for ulcerative colitis and the general population ', Journal of Crohn's and Colitis, vol. 8, no. 2, pp. 107-112 . https://doi.org/10.1016/j.crohns.2013.07.001 |
| ISSN: | 1873-9946 |
| Popis: | Background Restorative proctocolectomy with ileal pouch - anal anastomosis (IPAA) is the preferred surgical treatment for ulcerative colitis (UC). Little is known of how the operation affects bone metabolism and fracture risk. The aim of this retrospective cohort study was to investigate fracture risk and serum markers of bone metabolism following IPAA in a national cohort of Danish UC patients. Methods Diagnostic codes for 1757 patients and 8785 controls were obtained from the National Patient Register while blood results were collected from a regional database. Postoperative fracture free survival was evaluated on a Kaplan–Meier plot. Fracture hazard ratios (HR) after IPAA were calculated from Cox proportional hazards regression analysis. Results Fracture risk after IPAA was significantly reduced (adjusted HR = 0.49, 95% CI: 0.43; 0.55, p < 0.001). Prior fractures and alcoholism independently increased fracture risk significantly. Osteoporotic fracture risk after IPAA was reduced, significantly for wrist fractures (aHR = 0.39, 95% CI: 0.22; 0.71, p = 0.002), and borderline insignificantly for spine fractures (aHR = 0.51, 95% CI: 0.26; 1.01, p = 0.054). Vitamin D and calcium levels were significantly higher in the patient group (61.2 nmol/L vs. 58.9 nmol/L, p = 0.04 and 1.24 mmol/L vs. 1.21 mmol/L, p < 0.01, respectively), while parathyroid hormone and phosphate levels were significantly lower (4.9 pmol/L vs. 6.2 pmol/L, p < 0.01 and 1.08 mmol/L vs. 1.12 mmol/L, p < 0.01, respectively). Conclusion Fracture risk after IPAA is significantly reduced compared to the general population. Prospective studies are needed to verify the biochemical results. |
| Databáze: | OpenAIRE |
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