P964 - PREVALENCE OF OSTEOPOROSIS IN ADULT PATIENTS ON HOME PARENTERAL NUTRITION

P964

PREVALENCE OF OSTEOPOROSIS IN ADULT PATIENTS ON HOME PARENTERAL NUTRITION

M. van der Werf^1,2,*, J. Swarts ¹, M. J. Serlie¹, P. Bisschop¹

¹Endocrinology and Metabolism (TPN & Intestinal Failure Clinic), Amsterdam Gastroenterology, Endocrinology and Metabolism, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, ²Faculty of Health, Nutrition and Sports, Nutrition and Dietetics, The Hague University of Applied Sciences, The Hague, Netherlands

Rationale: Patients with intestinal failure (IF) are at high risk for metabolic bone disease (MBD). The ESPEN-guideline recommends regular assessment of bone mineral density (BMD) in patients on home parenteral nutrition (HPN).¹ This study aims to determine the prevalence of osteoporosis in patients with IF type II & III after 1 year of HPN use.

Methods: We conducted a retrospective cohort study, including all adult patients treated with HPN for at least 1 year with a minimum of 3 days per week between 1997 and 2024 at a single university hospital. The primary outcome was the prevalence of osteoporosis, defined as a T-score ≤-2.5 SD for patients ≥50 years, a Z-score ≤-2 SD for those <50 years or patients with moderate or severe vertebral fractures. BMD at the lumbar spine, femoral neck and total hip was measured by dual-energy X-ray absorptiometry.

Results: Out of 699 patients, 538 were excluded due to lack of consent (n=217), missing DXA-scan data (n=226), or not meeting HPN criteria (n=95), resulting in 161 patients. The cohort included 59 men (37%) and had a median age of 56 years (range 18-93). Short bowel syndrome was present in 77 patients (48%), and intestinal dysmotility in 40 patients (25%). The median duration on HPN was 716 days (IQR 582 days). Osteoporosis was present in 68 patients (42%). Those with osteoporosis had a lower body mass index (median 21.23 vs. 23.46 kg/m², p<0.001) and more frequent use of systemic corticosteroids (22% vs. 9%, p=0.03). They also had more fractures compared to patients with normal BMD or osteopenia (28% vs 10%, p=0.005).

Conclusion: In adult patients with IF type II and III on HPN, the prevalence of osteoporosis after one year of HPN was 42%. These findings underscore the necessity of regular BMD assessments and osteoporosis risk factor optimization. 

References: Pironi L, Cuerda C, Jeppesen PB. ESPEN guideline on chronic intestinal failure in adults - Update 2023. Clin Nutr. 2023 Oct;42(10):1940-2021

Disclosure of Interest: None declared