González D, Mazure R, Mautalen C, Vazquez H, Bai J
Sección Osteopatías Médicas, Hospital de Clínicas, Buenos Aires, Argentina.
Bone. 1995 Feb;16(2):231-4. doi: 10.1016/8756-3282(94)00034-w.
Body composition and bone mineral density (BMD) were studied by X-ray absorptiometry in 20 untreated and 12 treated women with celiac disease, as well as in 85 age-matched control women. Untreated patients had a significantly lower body weight, fat mass, lean tissue mass and BMD at the lumbar spine and total skeleton compared to controls (p < 0.001 for all parameters). Treated patients had also a significantly lower body weight (p < 0.01) fat mass (p < 0.05) and bone mineral density at lumbar spine and total skeleton (p < 0.05) compared with controls, but lean tissue mass was not diminished. However, treated patients had a significantly higher body weight, fat mass and BMD of the total skeleton compared with untreated celiac patients (p < 0.01 for all parameters). Serum alkaline phosphatase levels were increased in untreated patients but serum 250HD was normal. In conclusion, celiac disease causes a global and almost universal reduction of fat mass and BMD. The results of this cross-sectional study suggest that osteopenia does not seem to be completely restored by adequate treatment. Alteration of vitamin D metabolism was not the cause of osteopenia in the majority of patients.
采用双能X线吸收法对20例未经治疗和12例已治疗的乳糜泻女性患者以及85例年龄匹配的对照女性进行了身体成分和骨密度（BMD）研究。与对照组相比，未经治疗的患者体重、脂肪量、瘦组织量以及腰椎和全身骨骼的骨密度均显著降低（所有参数p<0.001）。与对照组相比，已治疗的患者体重（p<0.01）、脂肪量（p<0.05）以及腰椎和全身骨骼的骨密度（p<0.05）也显著降低，但瘦组织量未减少。然而，与未经治疗的乳糜泻患者相比，已治疗的患者体重、脂肪量和全身骨骼骨密度显著更高（所有参数p<0.01）。未经治疗的患者血清碱性磷酸酶水平升高，但血清250HD正常。总之，乳糜泻导致脂肪量和骨密度全面且几乎普遍降低。这项横断面研究结果表明，充分治疗似乎无法完全恢复骨质减少。大多数患者维生素D代谢改变并非骨质减少的原因。
