title: Bone mass and metabolism in Whipple's disease: the role of hypogonadism.
abstract: BACKGROUND
  Whipple's disease, like other malabsorption syndromes, ought to predispose to osteopenia. We therefore evaluated bone mass and mineral metabolism in a cohort of patients with this condition.
  
  
  METHODS
  Twelve male patients with Whipple's disease and 36 male age-matched healthy subjects took part in the study. None of the patients complained of diarrhea at the time of the study. Bone mineral density at the lumbar and femoral level and serum levels of indices of bone and mineral metabolism and of gonadal function were measured.
  
  
  RESULTS
  Bone mineral density at the total femur and femoral neck were significantly lower in patients with Whipple's disease than in healthy volunteers, whereas no significant difference was found at the lumbar level. In patients with Whipple's disease serum levels of type-I collagen teleopeptide (ICTP) and sex-hormone-binding globulin were significantly higher, whereas serum levels of testosterone and luteinizing hormone were significantly lower than in healthy volunteers. Moreover, testosterone correlated significantly (P < 0.05) with lumbar bone mineral density (r(s) = 0.64) and serum ICTP levels (r(s) = -0.63).
  
  
  CONCLUSIONS
  In patients with previously treated Whipple's disease and without any current symptoms of malabsorption, bone loss is generally moderate and linked to the presence of hypogonadism.
authors.affiliation: Dept. of Internal Medicine, Catholic University, Rome, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Di Stefano
authors.forename: R A
authors.initials: RA
authors.lastname: Jorizzo
authors.forename: G
authors.initials: G
authors.lastname: Brusco
authors.forename: L
authors.initials: L
authors.lastname: Cecchetti
authors.forename: G
authors.initials: G
authors.lastname: Sciarra
authors.forename: S
authors.initials: S
authors.lastname: Loperfido
authors.forename: G
authors.initials: G
authors.lastname: Brandi
authors.forename: G
authors.initials: G
authors.lastname: Gasbarrini
authors.forename: G R
authors.initials: GR
authors.lastname: Corazza
mesh_terms: D015519:Bone Density; D001842:Bone and Bones / Q000378:metabolism*; D016022:Case-Control Studies; D015331:Cohort Studies; D006801:Humans; D007006:Hypogonadism / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D008061:Whipple Disease / Q000378:metabolism* / Q000503:physiopathology