Osteoporosis in patients with intestinal insufficiency and intestinal failure: Prevalence and clinical risk factors.
Clin Nutr. 2017 Aug 5. pii: S0261-5614(17)30259-5. doi: 10.1016/j.clnu.2017.07.018. [Epub ahead of print]
Nygaard L1, Skallerup A2, Olesen SS3, Køhler M2, Vinter-Jensen L4, Kruse C5, Vestergaard P5, Rasmussen HH4.
A poor gut increases the risk of many Vitamin D and Magnesium related diseases
- Gut problems associated with low vitamin D – invited review Dec 2015
- Intestinal absorption of vitamin D – systematic review Aug 2017
- 88 percent of Intestinal failures had both low vitamin D and low bone density – Feb 2013
- Gut-Friendly forms of vitamin D
such as: bio-emulsion, topical, spray, sublingual, inhaled, injection, UVB . . .
- Magnesium Bioavailability - 2005 has the following
" Mg absorption occurs along the entire intestinal tract but the distal small intestine (jejunum and ileum) are the primary sites"
- MAGNESIUM IN MAN - IMPLICATIONS FOR HEALTH AND DISEASE – review 2015 has a section "Magnesium in Intestine"
- Magnesium Reduces Osteoporosis - Infographic June 2014
- Bone diseases related to many Vitamin D diseases – June 2016
- 20X increase in vitamin D sold and 36 percent decrease in osteoporosis business in Australia – Nov 2013
- Overview Gut and vitamin D - gut problems in lower left of chart on that page
BACKGROUND & AIMS:
Intestinal insufficiency and intestinal failure are associated with malabsorption of micro- and macronutrients that may negatively influence bone metabolism and increase the risk for developing osteoporosis. However, information regarding prevalence and contribution of individual risk factors is scarce. We investigated the prevalence of osteoporosis in patients with intestinal insufficiency and intestinal failure and identified associated risk factors.
This was a retrospective cross-sectional study including 167 clinically stable outpatients with intestinal insufficiency or intestinal failure. Bone mineral density (BMD) was measured by dual X-ray absorptiometry and the prevalence of osteoporosis was compared to a gender and age matched population. Several clinical and demographic parameters, including body mass index (BMI), vitamin-D, smoking habits and medications, were analyzed for association with BMD.
The prevalence of osteoporosis was 56.9% in the combined patient group compared to 24.1% in the control group (OR 4.2 [95% CI, 2.3 to 7.7]; p < 0.001).
- BMD in the hip was independently associated with BMI (0.13 [95% CI, 0.09 to 0.18]; p < 0.001) and
- vitamin-D levels (-0.41 [95% CI, -0.76 to -0.06]; p = 0.03).
Similar associations were seen for BMD in the spine (0.15 [95% CI, 0.08 - 0.22]; p < 0.001) and (-0.60 [95% CI, -0.76 to -0.06]; p = 0.02), respectively. Trends for low BMD were observed in smokers, and in patients using glucocorticoids, opioids, and proton pump inhibitors.
Patients with intestinal insufficiency and intestinal failure are at immense risk of developing osteoporosis. Low BMI and vitamin-D deficiency were identified as independent risk factors.
PMID: 28823627 DOI: 10.1016/j.clnu.2017.07.018