Normal parathyroid function with decreased bone mineral density: RESULTS Part 3

vitamin DBMD: Table 3 presents the results of lumbar and femoral BMD in the 17 patients. Compared with normal individuals of the same age (Z score), they had significantly lower lumbar BMD (-0.076±1.15 SDs, P<0.05) and femoral BMD (-0.60±0.96 SDs, P<0.05). Furthermore, six individuals had values less than -1 SDs at each site. Compared with young normal control subjects (T score), mean lumbar BMD (-1.4± 1.3 SDs, P<0.001) and femoral BMD (-1.3±0.9 SDs, P<0.001) were decreased by more than 1 SD in the 17 patients. Three patients were osteoporotic (less than -2.5 SDs) at the lumbar site, and two at the femoral site, while seven were osteopenic (less than -1 SDs and greater than -2.5 SDs) at the lumbar site, and eight at the femoral site. Fifty-nine per cent of the patients were either osteopenic or osteoporotic. Lumbar BMD (Table 4) was correlated with femoral BMD (R=0.641, P<0.01), age (R=-0.538, P<0.05), weight (R=0.664, P<0.005), height (R=0.706, P<0.005) and I-PTH (R=0.550, P<0.05) by regression analysis. In the latter case (I-PTH), the relationship was entirely explained by three patients – two with the lowest BMD and PTH values, and one with the highest BMD and PTH values. Only height remained significant by multivariate regression analysis (F=11.4, P<0.005). This was also true with logistical regression using lumbar T score less than -1 SDs as the threshold because height was identified as the only important covariate (X2=6.9, P<0.01). Femoral BMD (Table 4) was correlated with lumbar BMD (R=0.641, P<0.01), weight (R=0.879, P<0.0001), height (R=0.714, P<0.001) and creatinine (R=0.552, P<0.05) by regression analysis. Only weight remained significant by multivariate regression analysis (F=45.9, P<0.0001). With logistical regression analysis using the criteria previously identified, only weight remained significant (X2=8.56, P<0.005). You will be glad to come across costing you very little money.

TABLE 3
Bone mineral density (BMD) measurements in patients with celiac disease

Lumbar BMD (n = 17)
g/cm2 1.04±0.16
Z score (SDs) —0.76±1.151
<—1>—2.5 SDs 6
T score (SDs) —1.4±1.3+
<—2.5 SDs 3
<—1>—2.5 SDs 7
Femoral BMD (n = 17)
g/cm2 0.85±0.13
Z score —0.60 ± 0.96*
<—1>—2.5 SDs 6
T score —1.3±0.9+
<—2.5 SDs 2
<—1>—2.5 SDs 8

P<0.05, P<0.001 versus reference population measured by dualenergy x-ray absorptiometry

TABLE 4
Determinants of bone mineral density (BMD) in celiac disease patients treated with a gluten-free diet

Lumbar BMD Femoral BMD
Determinants R P R P
Age (years) -0.538 <0.05 -0.407 0.104
Weight (kg) 0.664 <0.005 0.879 <0.0001
Height (cm) 0.706 <0.005 0.714 <0.001
I-PTH (pmol/L) 0.550 <0.05 0.177 0.500
Creatinine (mmol/L) 0.419 0.094 0.552 <0.05
Lumbar BMD 0.641 <0.01
Femoral BMD 0.641 <0.01

Statistical analysis by simple linear regression (n = 17). I-PTH Intact parathyroid hormone

About

So Many Advances in Medicine, So Many Yet to Come