Endocrine and metabolic manifestations in inflammatory bowel disease

Stelios Tigas, Agathocles Tsatsoulis, Stelios Tigas, Agathocles Tsatsoulis

Abstract

Extraintestinal manifestations from nearly every organ system are common in inflammatory bowel disease (IBD). This review article describes the epidemiology, pathogenesis, diagnosis and management of the main endocrine and metabolic manifestations in IBD, including metabolic bone disease, growth retardation, hypogonadism, pubertal delay, lipid abnormalities and insulin resistance. These clinical problems are commonly interrelated and they share a common basis, influenced by disease-related inflammation and nutritional status. In addition to nutritional support, every effort should be made to achieve and maintain disease remission, thus correcting the underlying chronic inflammation. The criteria for screening and diagnosing osteoporosis are described and treatment options are discussed (lifestyle advice, vitamin D and calcium supplementation, use of bisphosphonates or other specific antiosteoporotic agents, correction of hypogonadism). Chronic glucocorticoid therapy may affect growth as well as predispose to osteoporosis. The diagnosis and management of growth failure, pubertal delay and hypogonadism in IBD are discussed.

Keywords: Inflammatory bowel disease; growth failure; hypogonadism; insulin resistance; lipids; osteoporosis.

Conflict of interest statement

Conflict of Interest: None

Figures

Figure 1
Figure 1
Management algorithm of osteoporosis in inflammatory bowel disease (IBD) [adapted from reference 10]. DXA, dual energy x-ray absorptiometry; BMD, bone mineral density

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