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Hip geometry, trabecular bone score, and bone mineral density in patients with celiac disease: a multi-center
Arzhang Naseri1, Alireza Keshtkar1, Ramina Mofarrah1
1Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Background:
Bone strength is influenced by the stiffness and spatial distribution of mineralized tissue. Bone mineral density (BMD) is used to assess osteoporosis but is limited in evaluating microarchitectural and geometric changes. We investigated Trabecular Bone Score (TBS), BMD, and hip structural analysis (HSA) in celiac disease (CD) patients.
Methods:
A cross-sectional study compared bone density factors in CD patients with a healthy control group matched for gender, BMI, and age. Dual-energy X-ray absorptiometry (DXA) assessed BMD at the femoral neck, hip, and lumbar spine (L1-L4). TBS was measured at the lumbar spine, and HSA evaluated geometry at the narrow neck (NN), femoral shaft (FS), and intertrochanteric (IT) regions.
Results:
The study included 73 CD patients and 93 healthy controls. The prevalence of low BMD for age at the lumbar spine, total hip, femoral neck, and at any skeletal site was significantly higher in the CD group compared with controls (P < 0.05). No significant differences were found in TBS between groups (P > 0.05). IT buckling ratio (BR), FS BR, and FS endocortical diameter were significantly higher in the CD group, while IT cortical thickness, FS cross-sectional area, and FS cortical thickness were significantly higher in controls (P < 0.05).
Conclusion:
Patients with celiac disease demonstrated adverse DXA-derived structural and densitometric skeletal parameters, which may potentially contribute to increased skeletal fragility, highlighting the importance of assessing both BMD and structural factors.
