Lower Limb Metaphyseal Bone Is Lost in Men with Coeliac Disease and Does Not Relate to Parathyroid Status.
Aims. To investigate regional lower limb bone density and associations with weight, PTH, and bone breakdown in coeliac men. Methods. From whole body DXA scans bone mineral density (BMD) was measured in 28 coeliac men, in the lower limb (subdivided into 6 regions, 3 being metaphyseal (mainly trabecular) and 2 diaphyseal (mainly cortical)). BMD at femoral neck (FN) and lumbar spine L2-4, body weight, height, serum calcium, alkaline phosphatase, parathyroid hormone (PTH), and urinary calcium and NTx/Cr, a measure of bone breakdown, were also measured. Age matched healthy men provided values for BMD calculation of z and T scores and for biochemical measurements. Results. Low BMD z scores were found at metaphyseal regions in the leg (p < 0.001) and in the FN (p < 0.05). The distal metaphyseal region BMD in the leg was lower than spine or FN (p < 0.05). PTH, urinary calcium/creatinine, and urinary NTx/Cr were similar to controls. Both metaphyseal and diaphyseal BMD z scores were associated with body weight (p < 0.02), but not with either PTH or urinary NTx/Cr. Conclusions. Low BMD lower limb regions comprising mostly trabecular bone occur early in CD and in the absence of elevated PTH or increased bone resorption. Low BMD is associated with low body weight.
Charles Salt Centre for Human Metabolism, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry SY10 7AG, UK; Institute of Medicine, University of Chester, Bache Hall, Chester CH1 4BJ, UK.
Michael W J
0000-0002-1235-0396
MW
Davie
Charles Salt Centre for Human Metabolism, Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry SY10 7AG, UK.
Sally F
SF
Evans
Institute of Medicine, University Centre Shrewsbury, University of Chester, The Guildhall, Frankwell Quay, Shrewsbury, Shropshire SY3 8HQ, UK.
Christopher A
0000-0002-5660-1361
CA
Sharp
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