CELIAC DISEASE IN OSTEOPOROSIS

骨质疏松症中的乳糜泻

• 批准号: 6381843
• 负责人: WILLIAM F. STENSON
• 金额: $ 30.18万
• 依托单位: BARNES-JEWISH HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-06-15 至 2005-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6381843
• 关键词: bone density; celiac disease; clinical research; diet therapy; dietary calcium; epidemiology; gastrointestinal disorder diagnosis; human data; human subject; human therapy evaluation; osteoporosis; patient care management; vitamin D

DESCRIPTION (Abstract of the application) There is compelling evidence that the prevalence of celiac disease in the general population in the United States is higher than is generally appreciated and that patients with the symptoms classically associated with celiac disease, primarily diarrhea and weight loss, form a relatively small portion of the total celiac population. Some patients with celiac disease have medical problems associated with the malabsorption of specific nutrients without having problems with diarrhea and weight loss. Celiac disease is associated with the malabsorption of calcium and vitamin D resulting in osteoporosis. Although the prevalence of osteoporosis in the population of patients with celiac disease is known to be increased compared to the prevalence in the general population, the contribution of celiac disease to osteoporosis in the general population and the prevalence of celiac disease in the population of patients with osteoporosis are unknown. The central hypotheses of this proposal are: 1. The prevalence of celiac disease in the population of patients with osteoporosis is significantly increased above that of the general population. 2. Management of osteoporotic patients with celiac disease would be facilitated by the diagnosis and treatment of their celiac disease. These two premises taken together would justify a public health recommendation for screening patients with osteoporosis with serological tests for celiac disease. We have the unique resource of a Bone Health Clinic with a database that includes more than 2,000 individuals with osteoporosis as well as an even larger number of patients with normal bone density. In addition, the Bone Health Clinic sees more than 750 new patients per year of which 50% have osteoporosis. We propose to use the resources of our Bone Health Clinic to test this hypothesis. We have two Specific Aims: 1. To define the prevalence of celiac disease in a population of patients with osteoporosis and to compare the prevalence in a case control group of individuals with normal bone mass indices. This Specific Aim will be pursued using patients from the Bone Health Clinic database that will already have been defined as having osteoporosis and new patients accrued to the Bone Health Clinic. If the prevalence of celiac disease in the osteoporotic population is high enough one could justify a public health recommendation that all patients with osteoporosis undergo serologic screening for celiac disease. Studies under this Specific Aim will also allow recommendation for which sequence of serologic tests is most likely to be helpful in identifying patients with osteoporosis who also have celiac disease. 2. To determine if there are any significant differences in the clinical histories, laboratory studies or response to therapy between the populations of newly diagnosed and previously untreated osteoporotic patients with and without celiac disease. Specific studies will include: a. We will compare the population of patients with osteoporosis and celiac disease with the population of patients with osteoporosis without celiac disease in terms of their clinical characteristics and biochemical parameters determined at the time of diagnosis. b. We will compare patients with osteoporosis and celiac disease with patients with osteoporosis without celiac disease in terms of their response to therapy. Patients with osteoporosis without celiac disease will receive calcium and vitamin D for one year, whereas patients with osteoporosis and celiac disease will receive calcium, vitamin D and a gluten-free diet for one year. At the end of the year of therapy, bone mass indices will be repeated and the response to the therapy of the two groups will be compared.

描述（应用程序的摘要） 有令人信服的证据表明，乳糜泻在 美国的一般人口高于一般值得赞赏的 并且患有经典症状的患者与腹腔疾病相关， 主要是腹泻和体重减轻，形成相对较小的部分 总腹腔种群。一些乳糜泻患者患有医疗 与特定养分的吸收不良相关的问题而没有 腹泻和体重减轻的问题。乳糜泻与 钙和维生素D的吸收不良导致骨质疏松症。虽然 乳糜泻患者人群中骨质疏松症患病率是 与普通人群的患病率相比，已知会增加 乳糜泻对普通人群骨质疏松症的贡献， 患者人群中乳糜泻的患病率 骨质疏松症是未知的。该提议的中心假设是：1。 骨质疏松症患者人群中乳糜泻的患病率是 显着增加了一般人群。 2。管理 诊断将促进乳糜泻的骨质疏松患者 和治疗其乳糜泻。这两个前提一起 为筛查骨质疏松症患者的公共卫生建议是合理的 与乳糜泻的血清学检查。我们拥有一个独特的资源 骨健康诊所的数据库，其中包括2000多个人 骨质疏松症以及骨骼正常的患者数量更大 密度。此外，骨骼健康诊所看到了750多名新患者 每年有50％的骨质疏松症。我们建议利用我们的资源 骨健康诊所以检验该假设。我们有两个具体的目标：1。 定义患有 骨质疏松症并比较病例对照组的患病率 患有正常骨质量指数的个体。将追求这个具体目标 使用骨骼健康诊所数据库的患者 被定义为骨质疏松症和新患者的骨骼健康 诊所。如果骨质疏松人群中乳糜泻的患病率是 足够高的人可以证明公共卫生的建议是所有患者 随着骨质疏松症进行腹腔疾病的血清学筛查。研究 这个具体目的还可以建议哪个顺序 血清学检查最有可能有助于识别患者 骨质疏松症的人也患有乳糜泻。 2。确定是否有 临床历史，实验室研究或 对新诊断和以前种群之间的治疗的反应 未经治疗的骨质疏松患者有或没有乳糜泻。具体的 研究将包括：我们将比较患者的人口 骨质疏松症和腹腔疾病，患者人数 就其临床特征而言，骨质疏松症没有乳糜泻 和在诊断时确定的生化参数。 b。我们将 比较患有骨质疏松症和乳糜泻的患者 骨质疏松症就其对治疗的反应而没有乳糜泻。 骨质疏松症的患者无腹腔疾病会接受钙， 维生素D一年，而骨质疏松和乳糜泻的患者 将接受一年的钙，维生素D和无麸质饮食。在最后 在治疗年度，将重复骨质量指数，并对 将比较两组的治疗。