P133 Risk Factors for the Occurrence and Severity of Vertebral Fractures in Inflammatory Bowel Disease Patients: A Nationwide Population-Based Cohort Study

Jung, S.H.(1)*;Kim, T.O.(2); Kang, S.B.(3);Kim, J.(4);

(1)Eunpyeong St. Mary's Hospital- The Catholic University of Korea, Department of Internal Medicine, Seoul, Korea- Republic Of;(2)Inje University Haeundae Paik-Hospital, internal medicine, Busan, Korea- Republic Of;(3)Daejeon St.Mary's Hospital, Internal medicine, Daejeon, Korea- Republic Of;(4)Eunpyeong St. Mary's Hospital, Internal medicine, Seoul, Korea- Republic Of;


The risk of vertebral fractures is increased in inflammatory bowel disease (IBD) patients. However, whether the severity of vertebral fractures differs between IBD patients and the general population, or between patients with Crohn’s disease and ulcerative colitis, is unknown.


We investigated risk factors associated with the occurrence and severity of vertebral fractures in IBD patients using The National Healthcare Insurance Service (NHIS) database.


From 2008 to 2018, there were 33,778 patients with IBD (24,370 UC patients and 9408 CD patients) and 101,265 patients in the reference population. The incidence rate ratio of vertebral fractures in IBD patients was 1.27 per 1000 person-years (95% CI 1.26–1.27). The risk of vertebral fracture was higher in CD and UC patients than in the matched reference group (HR 1.593; 95% CI 1.317–1.927; p < 0.001 and HR 1.269; 95% CI 1.141–1.412; p < 0.01 respectively). The occurrence of vertebral fracture was associated with Crohn’s disease, older age, female sex, high Charlson Comorbidity Index (CCI) score, and long-term steroid use. The severity of vertebral fractures was associated with IBD and older age.

graphic abstract


Vertebral fractures occur frequently and more severely in IBD patients, particularly those with CD. Therefore, we suggest monitoring of bone density, regular vitamin D supply, and reducing the use of corticosteroids to prevent vertebral fractures in IBD patients who are older, female, or have comorbidities.