RESUMO
Aim: The current study aims to evaluate bone mineral density (BMD) in patients with celiac disease who were referred to the celiac clinic of Shahid Rahimi Hospital in Khorramabad, Iran, in 2020. Background: Extraintestinal presentations of celiac disease are widespread and, if neglected, can be devastating. Osteoporosis, one of the extraintestinal manifestations of celiac disease, often remains undiagnosed until advanced stages and can impose a significant burden on patients with celiac and health systems. Nonetheless, the prevalence and characteristics of osteoporosis in celiac disease are unknown in Iran. Methods: This was a cross-sectional study at the celiac clinic of Shahid Rahimi Hospital in Khorramabad, Iran. Participants were 48 patients under 18 years diagnosed with Marsh II and Marsh III stages of celiac disease (who need to be on a gluten-free diet) at the pediatrics celiac clinic in 2020. All patients were recruited, completed a questionnaire, and had their blood biochemical parameters analyzed. Then their bone mineral density (BMD) was measured through dual-energy x-ray absorptiometry at the Asia Imaging Center in Khorramabad under the supervision of a radiologist and pediatric rheumatologist. Results: The mean age of the children was 9.96±3.17 years. The minimum and maximum ages of the participants were 4 and 17 years, respectively. Of all 48 children who were included (48), 34 (70.8%) were female, and 14 (29.2%) were male. In the femoral region bone densitometry, 35.4% were normal, 41.7% had lower limit normal, and 22.9% had low bone density. In the lumbar region, 39.6% were normal, 25% were Lower limit normal, and 35.4% had low bone density. No significant correlation was found between age, sex, place of residence, Marsh stage, gluten-free diet, and bone densitometry in both lumbar and femoral regions. Nonetheless, we detected a statistically significant relationship between bone density in the lumbar region and two HLA types, namely HLA DQ8 and HLA DQ2/8 (P=0.016). Conclusion: The results of the current study provided further evidence that all children with advanced celiac disease should be screened for metabolic bone diseases. Besides those in Marsh II and Marsh III, patients in Marsh I stage should also be investigated for low bone mineral density.
RESUMO
BACKGROUND: Celiac disease (CD) is a disorder associated with body reaction to gluten. After the gluten intake, an immune reaction against the protein occurs and damages villi of small intestine in celiac patients gradually. OBJECTIVES: The OSC, a filtering method for minimization of inter- and intra-spectrometer variations that influence on data acquisition, was applied to biofluid NMR data of CD patients. PATIENTS AND METHODS: In this study, metabolites of total 56 serum samples from 12 CD patients, 15 CD patients taking gluten-free diet (GFD), and 29 healthy cases were analyzed using nuclear magnetic resonance (NMR) and associated theoretical analysis. Employing ProMetab (version ProMetab_v3_3) software, data obtained from NMR spectra were reduced and orthogonal signal correction (OSC) effect on celiac disease metabonomics before and after the separation by principle component analysis (PCA) was investigated. RESULTS: The three groups were separated by OSC and findings were analyzed by partial least squares discriminant analysis (PLS-DA) method. Root mean square error of calibration (RMSEc) and correlation coefficient of calibration (Rc) for PLS-DA referred to an efficient group separation filtered by OSC. CONCLUSIONS: The applied leave-one-out cross-validation to PLS-DA method performed along with OSC confirmed validation of data analysis. Finally four metabolites are introduced as CD biomarkers.
