Calcaneal ultrasound attenuation and vitamin-D-receptor genotypes in celiac disease.
BACKGROUND
Osteopenia is common in patients with celiac disease and is believed to result from malnutrition. Osteoporosis in otherwise healthy individuals is related to genetically determined polymorphisms within the vitamin-D-receptor (VDR) gene. We hypothesized that in celiac patients particular genes of the VDR enhance the susceptibility for malnutrition-associated low-bone density.


METHODS
We determined allelic frequencies within the VDR gene by restriction fragment length polymorphism analysis in 92 patients with celiac disease (age, 15-83 years). Thirty-eight patients were on a gluten-free diet; 54 patients did not adhere to a diet. The determined VDR polymorphisms in 111 unrelated newborns served as controls. Osteopenia was determined by means of ultrasound measurements of the calcaneus (n = 78). Bone turnover was estimated by osteocalcin determination (n = 60).


RESULTS
There was no difference in the frequency of the VDR gene polymorphisms in patients with celiac disease compared with controls. Adjusted ultrasound measures of the calcaneus were low in 47% of patients, but there was no difference of the VDR gene frequencies in these patients compared with those with normal ultrasound results or controls. Bone turnover was higher in patients without a gluten-free diet (P = 0.02). Again, there was no association with any particular VDR gene.


CONCLUSIONS
Patients with celiac disease frequently have osteopenia, which is not related to any of the determined genes within the VDR.
Vogelsang
H
H
Clinic of Internal Medicine IV, Dept. of Gastroenterology and Hepatology, University of Vienna, Austria.
Suk
E K
EK
Janisiw
M
M
Stain
C
C
Mayr
W R
WR
Panzer
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000209:etiology* / Q000235:genetics; D016723:Bone Remodeling / Q000502:physiology; D002111:Calcaneus / Q000000981:diagnostic imaging / Q000502:physiology; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications / Q000235:genetics* / Q000503:physiopathology; D004035:Diet Therapy; D005260:Female; D005838:Genotype; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D018167:Receptors, Calcitriol / Q000235:genetics*; D012307:Risk Factors; D014463:Ultrasonography; D014808:Vitamin D Deficiency
D018167:Receptors, Calcitriol