# Risk Factors and Awareness of Bone Fragility in Inflammatory Bowel Disease in Taiwan: A Cross-Sectional Study

## TL;DR

This study in Taiwan finds that IBD patients often have low bone density, with vitamin D deficiency and hormone issues being key risk factors, and education improves awareness.

## Contribution

The study is the first in Taiwan to investigate risk factors and awareness of bone fragility in IBD patients.

## Key findings

- 30.5% of IBD patients had low bone mineral density (BMD), including osteopenia and osteoporosis.
- Age and sex hormone deficiency were strongly associated with low BMD in IBD patients.
- Educational interventions significantly improved patients' self-assessed knowledge of bone health.

## Abstract

Background/Objectives: Patients with inflammatory bowel disease (IBD) are at a higher risk of developing bone disorders. Awareness and understanding of the disease are crucial for prevention and early diagnosis. Currently, there is no research on the risk factors and knowledge of bone fragility in the population with IBD in Taiwan. This study aimed to evaluate the risk factors and self-assessed knowledge levels of bone health among patients with IBD in Taiwan. Methods: This single-center cross-sectional study included 59 adult patients. Clinical data, blood tests, bone mineral density (BMD), T-score, Z-score, and questionnaires covering self-assessed knowledge, fracture risks, and physical activity were assessed. The patients were divided into normal and low BMD groups. Results: Of all participants, eighteen (30.5%) had low BMD: six (10.2%) had BMD below the expected range, ten (16.9%) had osteopenia, and two (3.4%) had osteoporosis. Vitamin D insufficiency and deficiency were observed in 26.3% and 66.6% of the patients, respectively. According to multivariate analysis, age and sex hormone deficiency are strongly associated with low BMD. Educational interventions significantly improved the patients’ self-assessed knowledge levels. Conclusions: Age and sex hormone deficiency are significant factors contributing to low BMD in IBD patients. Not only women but also men with IBD who had symptoms of hypogonadism are at high risk for low BMD. Educational interventions improve self-assessment knowledge regarding the relationship between IBD and bone health.