PhD Scientific Days 2022

Budapest, 6-7 July 2022

Pharmaceutical Sciences I.

Microscopic Colitis is a Risk Factor for Low Bone Density: Systematic Review and Meta-analysis

Anett Rancz1,2, Brigitta Teutsch1,3, Marie Anne Engh1, Dániel Veres4, László Földvári-Nagy5, Bálint Erőss1,6, Nóra Hosszúfalusi2, Márk Félix Juhász3,7, Péter Hegyi1,6, Emese Mihály2
1 Centre for Translational Medicine, Semmelweis University, Budapest, Hungary;
2 Department of Internal Medicine and Hematology, Semmelweis University, Medical School, Budapest, Hungary;
3 Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary;
4 Semmelweis University Department of Biophysics and Radiation Biology, Semmelweis University, Budapest, Hungary;
5 Department of Morphology and Physiology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary;
6 Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary;
7 Heim Pál National Pediatric Institute, Budapest, Hungary;

Text of the abstract

Background: Microscopic colitis (MC), is a chronic inflammatory disease characterized by watery diarrhoea, which substantially decreases the patient's quality of life. Moreover, low bone density (LBD) has been associated with the disease. Furthermore, many risk factors contribute to the random coincidence of the two conditions.
Aims: We aimed to assess if MC is a risk factor for LBD. We also estimated the proportions of bone mineral changes in patients with MC.
Method: Our protocol was prospectively registered with PROSPERO (CRD42021283392). We systematically searched five databases from inception to the 16th of October, 2021 (Pubmed, Embase, Cochrane, Scopus, Web of Science). We used the random-effect model to calculate pooled odds ratios (ORs) and pooled event rates with 95% confidence intervals (CI). We assessed the risk of bias with the aid of the QUIPS tool for the prognostic question, and we applied the JBI Critical Appraisal Checklist for Prevalence Studies in the proportional measurements. To ascertain the quality of evidence of our outcomes we followed the recommendations of the GRADE working group.
Results: The systematic search yielded a total of 3046 articles. Four articles were eligible for quantitative synthesis. Three of them used age- and sex-matched controls to evaluate the occurrence of LBD among patients with MC. We analysed 111 patients with MC among them 67 had LBD compared to 265 controls with 110 LBD cases. The odds of having LBD were threefold higher (OR =2.96, CI: 1.15–7.59) in the presence of MC. The proportion of LBD was 0.68 (CI: 0.56–0.78), osteopenia was 0.51 (CI: 0.43–0.58) and osteoporosis was 0.11 (CI: 0.07–0.16) among the MC population. Most of the studies carried a high risk of bias due to the low number of study participants, while the certainty of the evidence was very low owing to the small sample sizes and because of the use of a surrogate outcome, measuring the bone mineral density.
Conclusion: Our data demonstrate that MC is associated with a threefold risk for LBD. We highly suggest screening patients for bone mineral density at the diagnosis of MC.
Funding: There was no funding.