Evolution of bone densitometry parameters and risk of fracture in coeliac disease: a 10-year perspective.

Autor: Tovoli F; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy. francesco.tovoli@unibo.it.; Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy. francesco.tovoli@unibo.it., Pallotta DP; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy., Giamperoli A; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy., Zavatta G; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.; Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Skoracka K; Doctoral School, Poznan University of Medical Sciences, Poznan, Poland.; Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, Poznan, Poland., Raiteri A; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy., Faggiano C; Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Krela-Kaźmierczak I; Department of Gastroenterology, Dietetics and Internal Diseases, Poznan University of Medical Sciences, Heliodor Swiecicki Hospital, Poznan, Poland., Granito A; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.; Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Jazyk: angličtina
Zdroj: Internal and emergency medicine [Intern Emerg Med] 2023 Aug; Vol. 18 (5), pp. 1405-1414. Date of Electronic Publication: 2023 Jun 03.
DOI: 10.1007/s11739-023-03307-7
Abstrakt: Background: Metabolic bone disease is frequently found in patients with coeliac disease (CD). Despite its high prevalence, international guidelines are partially discordant about its management due to the lack of long-term data.
Methods: We retrospectively evaluated a large dataset of prospectively collected data of CD patients assessing the variation of DXA parameters and estimated fracture risk according to the FRAX ® score in a 10-year follow-up. Incident fractures are reported, and the predictive ability of the FRAX ® score is verified.
Results: We identified 107 patients with low bone density (BMD) at the diagnosis of CD and a 10-year follow-up. After improving at the first follow-up, T-scores slowly reduced over time but with no clinically relevant differences between the first and last examination (lumbar spine: from - 2.07 to - 2.07, p = 1.000; femoral neck: from - 1.37 to - 1.55, p = 0.006). Patients with osteoporosis at the index measurement had more marked fluctuations than those with osteopenia; the latter group also showed minimal modifications of the FRAX ® score over time. Six incident major fragility fractures occurred, with a good predictive ability of the FRAX ® (AUC 0.826).
Conclusion: Adult CD patients with osteopenia and no risk factors had substantially stable DXA parameters and fracture risk during a 10-year follow-up. A dilated interval between follow-up DXA for these patients could be considered to reduce diagnosis-related time and costs, maintaining a 2-year interval for patients with osteoporosis or risk factors.
(© 2023. The Author(s).)
Databáze: MEDLINE
Externí odkaz: