Kemppainen T, Kröger H, Janatuinen E, Arnala I, Lamberg-Allardt C, Kärkkäinen M, Kosma V M, Julkunen R, Jurvelin J, Alhava E, Uusitupa M
Department of Clinical Nutrition, University of Kuopio, Finland.
Bone. 1999 Sep;25(3):355-60. doi: 10.1016/s8756-3282(99)00171-4.
The purpose of our study was to investigate the recovery of bone disease in celiac patients during 5 years of a gluten-free diet. The study group consisted of 28 newly diagnosed celiac patients (9 men, 19 women) recruited between 1990 and 1991. Six patients withdrew from the 5-year follow-up. Compliance with the gluten-free diet was good: 96% at 1 year and 82% at 5 years. During the follow-up period, the body mass index increased significantly (8%). Both in men and women, bone mineral density (BMD) values determined by dual X-ray absorptiometry (DXA) increased at the lumbar spine (2%), the femoral neck (1%), the trochanter (6%), and the Wards' area (3%) during the follow-up. The increase in BMD was found already during the first year of follow-up. After 1 year, BMD increased or remained the same in 69% of the patients at the lumbar spine and in 67% of the patients at the femoral neck, 89% of patients at the throchanter, and 67% of patients at the Wards' area. During the 5-year follow-up, these figures were 52%, 46%, 68%, and 59%, respectively. At the baseline, 19 out of 28 patients, after 1 year, 14 out of 26 patients, and after 5 years, 2 out of 26 patients had low serum 25(OH)D vitamin values (p = 0.0001). A high serum parathormone value was noticed in 6 out of 25 patients at the baseline, but after 1 year, 5 of them showed normalized values (p = 0.03). According to our results, bone disease in celiac patients is cured in most patients during 5 years on a gluten-free diet. The improvement in BMD mostly occurred already within the first year after the establishment of a gluten-free diet.
我们研究的目的是调查腹腔疾病患者在采用无麸质饮食5年期间骨病的恢复情况。研究组由1990年至1991年招募的28例新诊断的腹腔疾病患者（9名男性，19名女性）组成。6例患者退出了5年的随访。对无麸质饮食的依从性良好：1年时为96%，5年时为82%。在随访期间，体重指数显著增加（8%）。在随访期间，通过双能X线吸收法（DXA）测定的男性和女性的骨矿物质密度（BMD）值在腰椎（2%）、股骨颈（1%）、大转子（6%）和沃德区（3%）均有所增加。BMD的增加在随访的第一年就已出现。1年后，腰椎69%的患者和股骨颈67%的患者BMD增加或保持不变，大转子89%的患者以及沃德区67%的患者BMD增加或保持不变。在5年的随访期间，这些数字分别为52%、46%、68%和59%。基线时，28例患者中有19例，1年后，26例患者中有14例，5年后，26例患者中有2例血清25(OH)D维生素值较低（p = 0.0001）。基线时，25例患者中有6例血清甲状旁腺激素值较高，但1年后，其中5例显示值已正常化（p = 0.03）。根据我们的结果，腹腔疾病患者的骨病在采用无麸质饮食5年期间在大多数患者中得到治愈。BMD的改善大多在无麸质饮食确立后的第一年内就已出现。
