Molteni N, Caraceni M P, Bardella M T, Ortolani S, Gandolini G G, Bianchi P
Patologia Medica III, Istituto di Scienze Mediche, Università di Milano, Italy.
Am J Gastroenterol. 1990 Jan;85(1):51-3.
Peripheral single photon absorptiometry was used to measure forearm bone mineral density in 22 celiacs on gluten-free diet from childhood (male 14, female 8, age 13-20) and 29 untreated adult celiacs at diagnosis (male 5, female 24, age 18-56, 14 with subclinical disease), compared with healthy sex- and age-matched controls. Bone mineral density was similar in patients treated from childhood and their controls [(668.4 +/- 65.3 vs. 654.9 +/- 69.6 mg/cm2, (mean +/- SD)], but significantly lower in untreated patients than in their controls (598.3 +/- 83.1 vs 673.2 +/- 42.7 mg/cm2, p less than 0.001). It was also significantly lower in the 12 younger untreated celiacs (18-28 yr) versus controls (619.4 +/- 68.5 vs 669.1 +/- 39.3 mg/cm2, p less than 0.01). In the untreated women, but not their controls, a negative correlation (p less than 0.05) was observed between bone mineral density and age. Bone mineral density did not correlate with severity of clinical or biochemical abnormalities. These results suggest that bone derangements are common in celiacs diagnosed in adulthood, even if they never presented evident malabsorption symptoms, and emphasize the importance of early diagnosis and treatment.
采用外周单光子吸收法测量了22名自幼接受无麸质饮食的乳糜泻患者（男14例，女8例，年龄13 - 20岁）和29例未经治疗的成年乳糜泻确诊患者（男5例，女24例，年龄18 - 56岁，其中14例为亚临床疾病）的前臂骨矿物质密度，并与性别和年龄匹配的健康对照者进行比较。自幼接受治疗的患者与其对照者的骨矿物质密度相似[（668.4±65.3对654.9±69.6mg/cm²，（均值±标准差）]，但未经治疗的患者的骨矿物质密度显著低于其对照者（598.3±83.1对673.2±42.7mg/cm²，p＜0.001）。12名年龄较小的未经治疗的乳糜泻患者（18 - 28岁）的骨矿物质密度也显著低于对照者（619.4±68.5对669.1±39.3mg/cm²，p＜0.01）。在未经治疗的女性患者中，而非其对照者中，观察到骨矿物质密度与年龄之间存在负相关（p＜0.05）。骨矿物质密度与临床或生化异常的严重程度无关。这些结果表明，成年期确诊的乳糜泻患者即使从未出现明显的吸收不良症状，骨紊乱也很常见，并强调了早期诊断和治疗的重要性。
