Kotze Lorete M S, Skare Thelma, Vinholi Antonella, Jurkonis Leandro, Nisihara Renato
Service of Gastroenterology, Cajuru Hospital, Pontifical Catholic University of Paraná , Brazil.
Rheumatology Unit, Evangelical University, Brasil.
Rev Esp Enferm Dig. 2016 Feb;108(2):84-8. doi: 10.17235/reed.2015.3953/2015.
Osteoporosis (OP) is a metabolic bone illness that may complicate celiac disease (CD). It can lead to devastating consequences because of low bone mass and fragility fractures.
To study the OP prevalence in a group of Brazilian patients with CD and the value of a gluten free diet (GFD).
Retrospective study of celiac female patients from a single University Center followed with bone densitometries. Results from densitometry made at first visit were compared with a second study after a median time of 5 years. During this period, patients were submitted to a GFD according to orientations from special program training. Calcium and vitamin D were prescribed to those patients who did not reach the minimal daily requirement through diet.
Forty-one celiac female patients, mean age 46.1 ± 14.8 years, were included. The prevalence of osteopenia at first visit was 56.1% and that of osteoporosis 29.2%. Osteoporosis was associated with longer disease duration (p = 0.01). The second densitometry was performed in a median time of 5 years (range 1 to 13 years) and disclosed 58.9% osteopenia and 28.2% osteoporosis. The GFD improved bone mass, mainly at (of) spine (comparison of T score with p = 0.03 and of bone mass in g/cm2 with p = 0.02), but it was not sufficient to reduce the number of osteopenic (p = 0.9) and osteoporotic patients (p = 0.4). During the follow up period 25% of osteoporotic patients developed low impact fractures.
Bone health is notably impaired at baseline in CD patients, especially in those with a diagnostic delay. A GFD modestly improved bone mass density with low impact fractures occurring in one third of patients during the follow up period.
骨质疏松症（OP）是一种代谢性骨病，可能并发乳糜泻（CD）。由于骨量低和脆性骨折，它会导致严重后果。
研究一组巴西CD患者的OP患病率以及无麸质饮食（GFD）的价值。
对来自单一大学中心的乳糜泻女性患者进行回顾性研究，并进行骨密度测量。将首次就诊时的骨密度测量结果与中位时间为5年后的第二次研究结果进行比较。在此期间，患者根据特殊项目培训的指导接受GFD。对于那些通过饮食未达到每日最低需求量的患者，给予钙和维生素D。
纳入41名乳糜泻女性患者，平均年龄46.1±14.8岁。首次就诊时骨量减少的患病率为56.1%，骨质疏松症的患病率为29.2%。骨质疏松症与疾病持续时间较长有关（p = 0.01）。第二次骨密度测量在中位时间5年（范围1至13年）进行，显示骨量减少的患病率为58.9%，骨质疏松症的患病率为28.2%。GFD改善了骨量，主要是脊柱的骨量（T评分比较p = 0.03，骨量以g/cm2计比较p = 0.02），但不足以减少骨量减少患者的数量（p = 0.9）和骨质疏松症患者的数量（p = 0.4）。在随访期间，25%的骨质疏松症患者发生了低能量骨折。
CD患者基线时骨骼健康明显受损，尤其是那些诊断延迟的患者。GFD适度改善了骨密度，随访期间三分之一的患者发生了低能量骨折。
