Beinmetabolisme hos nydiagnostiserte cøliakipasienter

Abstract

Bone metabolism in patients with newly diagnosed caeliac disease. Evita Deressa, Anne Cathrine Wammer, Jan Arvid Falch, Jørgen Jahnsen

Background. Caeliac disease is an immune-mediated enteropathy induced by gluten in genetically predisposed individuals. Malabsorption of vitamins and minerals is a common finding in untreated patients and disturbance in bone metabolism is therefore a suspected complication. We wanted to assess vitamin D status, parathyroid hormone (PTH) and bone mineral density (BMD) in patients with newly diagnosed caeliac disease. Material and methods. Altogether 118 patients (93 females) were investigated. Median age was 42.5 years (range 20 - 87 years). Vitamin D metabolites, PTH and biochemical markers of bone metabolism were measured in blood. Lumbar spine, femoral neck and total body BMD were measured by dual x-ray absorptiometry (DXA); Z scores were obtained by comparison with locally derived age- and sex matched reference values. Results. Vitamin D deficiency (25-hydroxyvitamin D < 30 nmol/l) was present in 20 % of the patients; 30 % of the patients had secondary hyperparathyroidism (PTH >=7.0 pmol/l). BMD was significantly reduced (p < 0.001) at all skeletal sites measured. There was no relationship between vitamin D status and BMD, but PTH was negatively correlated to BMD at all skeletal sites (p < 0.005). Body mass index (BMI) was positively correlated to BMD in these patients (p < 0.001). Conclusion. Hypovitaminosis D and secondary hyperparathyroidism are common in patients with newly diagnosed caeliac disease in addition to low BMD.