Background: Patients with inflammatory bowel disease (IBD), including Crohn’s disease (CD) and ulcerative colitis (UC), are often treated with steroids to alleviate their symptoms. Prolonged corticosteroid use can lead to decreased bone mineral density (BMD). However, the impact of steroid treatment regimens on BMD in patients with IBD is not fully understood. This study aimed to investigate the effects of corticosteroid therapy on BMD in IBD patients. Methods: A predetermined protocol registered in the PROSPERO registry under reference CRD42024518193. We searched the MEDLINE, EMBASE, Web of Science, and Cochrane Library databases to identify studies reporting the BMD of IBD before April 2024. Studies were evaluated using the Newcastle–Ottawa Scale. Sensitivity analyses and Begg’s asymmetric test were used to detect bias. Results: Following screening and evaluation, a meta-analysis of steroid odds ratios (ORs) of BMD in IBD was conducted based on 18 selected studies, with a total of 27,716 participants. The abnormal BMD in IBD was with an odds ratio (OR) of 2.31 (95% confidence interval CI: 1.19–4.48), osteoporosis in IBD with OR of 1.62 (95% CI: 1.02–2.58), osteoporosis in CD with an OR of 1.21 (95% CI: 0.85–1.73), osteoporosis in UC with an OR of 1.00 (95% CI: 0.87–1.16), abnormal BMD in CD with OR of 1.02 (95% CI: 0.99–1.06), abnormal BMD in UC with OR of 1.44 (95% CI: 1.07–1.95). Conclusion: Patients diagnosed with IBD who received glucocorticoid therapy did not show a significant increase in osteoporosis (BMD T ≤ −2.5), especially in the UC group, despite having a higher tendency for bone loss (BMD T ≤ −1). The osteoporosis observed in IBD patients may require further comprehensive exploration and clarification.
Li et al. (Fri,) studied this question.