UTICAJ KORTIKOSTEROIDNE TERAPIJE NA NASTANAK OSTEOPOROZE U KRONOVOJ BOLESTI

Mirela Bašić Denjagić, Nada Pavlović-Čalić, Nedima Kapidžić-Bašić, Nermin Salkić

Systemic corticosteroids (CS) are often used in treatment of Crohn’s disease and are usually considered the main cause of osteoporosis in patients with Crohn’s disease. The aim of this paper was to assess the influence of CS on development of osteoporosis in Crohn’s disease. In this study bone mass density (BMD) was analyzed in 43 patients with Crohn’s disease. Most of the examined patients (72.1%) used CS for more than 3 months. Osteoporosis was diagnosed in 30.2% of patients, and osteopenia in 44.2% of patients. There were no statistically significant difference in BMD among patients who were on CS and the ones who were not. In the group of newly diagnosed patients 60% had reduced bone density, opposing 61.6% of patients with previously diagnosed disease. There was no statistically significant difference among those two groups of patients. Risk factor such as corticosteroid therapy is not independent risk factor for reduced BMD. Newly diagnosed patients have high prevalence of reduced BMD and they were not on CS therapy, which suggest that possible inflammatory nature of the disease is a possible risk factor for reduced BMD in Crohn’s disease.

Sistemski kortikosteroidi (KS) koji se često koriste u terapiji Kronove bolesti smatraju se glavnim krivcem za nastanak osteoporoze kod tih bolesnika. Cilj rada je bio utvrditi uticaj KS na nastanak osteoporoze u Kronovoj bolesti. U ovoj studiji analizirana je gustina kostiju (BMD) u 43 bolesnika oboljela od Kronove bolesti. Najve- ći broj ispitanika (72,1%) je koristio KS više od 3 mjeseca. Osteoporoza je dijagnostikovana u 30,2%, a osteopenija u 44,2% bolesnika. Nije nađena signifi kantna razlika u učestalosti poremećaja gustine kosti između ispitanika koji su uzimali KS i koji nisu. U grupi novootkrivenih bolesnika 60% ispitanika je imalo smanjenu gustinu kosti nasuprot 61,6% ispitanika sa prethodno otkrivenom bolešću. Nije bilo signifikantne razlike u postotku ispitanika sa smanjenom gustinom kosti između novootkrivenih i ranije verificiranih bolesnika. Riziko faktori poput kortikosteroida nisu neovisni faktori rizika za sniženje BMD. Novootkriveni bolesnici imaju visoku prevalencu sniženog BMD, a nisu bili na terapiji KS, što ukazuje da je sama infl amatorna priroda bolesti mogući faktor rizika za BMD.