Related Experiment Videos
Normal parathyroid function with decreased bone mineral density in treated celiac disease
B Lemieux1, M Boivin, J H Brossard
1Centre hospitalier de l'Université de Montréal - Hôpital Saint-Luc, Montréal, Canada.
Summary
Patients with celiac disease on a gluten-free diet show higher basal parathyroid hormone (PTH) levels but normal parathyroid function. Bone mineral density (BMD) remains lower, with height and weight being key determinants of bone mass.
Area of Science:
- Endocrinology
- Gastroenterology
- Bone Metabolism
Background:
- Celiac disease is linked to decreased bone mineral density (BMD) and secondary hyperparathyroidism.
- The long-term effects of a gluten-free diet on parathyroid function in celiac patients require further investigation.
Purpose of the Study:
- To assess persistent parathyroid hormone (PTH) elevation and parathyroid function in treated celiac disease patients.
- To evaluate bone mineral density (BMD) and its determinants in this cohort.
Main Methods:
- Measured basal calcium, phosphate, intact PTH (I-PTH), and vitamin D levels in 17 treated celiac patients and 26 controls.
- Assessed parathyroid function via calcium chloride and sodium citrate infusions in seven patients and seven controls.
- Evaluated BMD using Z and T scores, comparing to a reference population.
Main Results:
- Treated celiac patients exhibited higher basal I-PTH levels (3.77 vs. 2.28 pmol/L, P<0.001) but normal parathyroid function.
- Mean vitamin D levels were normal; BMD was significantly lower at the hip and lumbar spine (Z scores -0.60 and -0.76, P<0.05).
- Osteopenia/osteoporosis was present in several patients; height and weight, not I-PTH, were significant determinants of BMD.
Conclusions:
- Treated celiac disease is associated with elevated basal I-PTH but normal parathyroid function.
- Lower BMD persists despite treatment, influenced primarily by height and weight.
- Findings suggest prior hyperparathyroidism may have resolved or adapted in treated patients.