Document Detail


Normal parathyroid function with decreased bone mineral density in treated celiac disease.
MedLine Citation:
PMID:  11381297     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Decreased bone mineral density (BMD) has been reported in patients with celiac disease in association with secondary hyperparathyroidism. The present study investigated whether basal parathyroid hormone (PTH) remained elevated and whether abnormalities of parathyroid function were still present in celiac disease patients treated with a gluten-free diet. Basal seric measurements of calcium and phosphate homeostasis and BMD were obtained in 17 biopsy-proven patients under treatment for a mean period of 5.7+/-3.7 years (range 1.1 to 15.9). In addition, parathyroid function was studied with calcium chloride and sodium citrate infusions in seven patients. Basal measurements of patients were compared with those of 26 normal individuals, while parathyroid function results were compared with those of seven sex- and age-matched controls. Basal results were similar in patients and controls except for intact PTH (I-PTH) (3.77+/-0.88 pmol/L versus 2.28+/-0.63 pmol/L, P<0.001), which was higher in the former group but still within normal limits. Mean 25-hydroxy vitamin D and 1,25-dihydroxy vitamin D values were normal in patients. Parathyroid function results were also found to be similar in both groups. Compared with a reference population of the same age (Z score), patients had significantly lower BMDs of the hip (-0.60+/-0.96 SDs, P<0.05) and lumbar spine (-0.76+/-1.15 SDs, P<0.05). T scores were also decreased for the hip (-1.3+/-0.9 SDs, P<0.0001) and lumbar spine (-1.4+/-1.35 SDs, P<0.0001), with two to three patients being osteoporotic (T score less than -2.5 SDs) and seven to eight osteopenic (T score less than -1 SDs but greater than or equal to -2.5 SDs) in at least one site. Height and weight were the only important determinants of BMD values by multivariate or logistical regression analysis in these patients. The results show higher basal I-PTH values with normal parathyroid function in treated celiac disease. Height and weight values are, but I-PTH values are not, an important determinant of the actual bone mass of patients. Normal parathyroid function in treated patients suggests a lack of previous severe secondary hyperparathyroidism and/or complete adaptation to prior changes in parathyroid function.
Authors:
B Lemieux; M Boivin; J H Brossard; R Lepage; D Picard; L Rousseau; P D'Amour
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Canadian journal of gastroenterology = Journal canadien de gastroenterologie     Volume:  15     ISSN:  0835-7900     ISO Abbreviation:  Can. J. Gastroenterol.     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-30     Completed Date:  2001-07-26     Revised Date:  2014-01-17    
Medline Journal Info:
Nlm Unique ID:  8807867     Medline TA:  Can J Gastroenterol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  302-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Absorptiometry, Photon
Adult
Aged
Analysis of Variance
Bone Density*
Bone Diseases, Metabolic / etiology*,  pathology,  radionuclide imaging*
Calcium Chloride / diagnostic use
Case-Control Studies
Celiac Disease / blood*,  complications*,  diet therapy
Citrates / diagnostic use
Female
Humans
Hyperparathyroidism, Secondary / blood,  etiology
Logistic Models
Male
Middle Aged
Osteoporosis / etiology*,  pathology,  radionuclide imaging*
Parathyroid Hormone / blood*
Chemical
Reg. No./Substance:
0/Citrates; 0/Parathyroid Hormone; 1Q73Q2JULR/sodium citrate; M4I0D6VV5M/Calcium Chloride

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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