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Bone Mineralization in Celiac Disease英文文献资料.doc

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Bone Mineralization in Celiac Disease英文文献资料

HindawiPublishingCorporation GastroenterologyResearchandPractice Volume2012,ArticleID198025,9pages doi:10.1155/2012/198025 ReviewArticle BoneMineralizationinCeliacDisease TizianaLarussa,EvelinaSuraci,ImmacolataNazionale,LudovicoAbenavoli, MariaImeneo,andFrancescoLuzza DepartmentofHealthScience,UniversityofCatanzaro“MagnaGraecia”,UniversityCampusofGermaneto,VialeEuropa, 88100Catanzaro,Italy CorrespondenceshouldbeaddressedtoFrancescoLuzza,luzza@unicz.it Received6January2012;Revised12March2012;Accepted3April2012 AcademicEditor:GovindK.Makharia Copyright?2012TizianaLarussaetal. This is an open access article distributed under the Creative Commons Attribution License,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkisproperly cited. Evidenceindicatesawell-establishedrelationshipbetweenlowbonemineraldensity(BMD)andceliacdisease(CD),butdataon thepathogenesisofbonederangementinthissettingarestillinconclusive.InpatientswithsymptomaticCD,lowBMDappearsto bedirectlyrelatedtotheintestinalmalabsorption.Adherencetoastrictgluten-freediet(GFD)willreversethehistologicalchanges intheintestineandalsothebiochemicalevidenceofcalciummalabsorption,resultinginrapidincreaseofBMD.Nevertheless,GFD improvesBMDbutdoesnotnormalizeitinallpatients,evenaftertherecoveryofintestinalmucosa.Othermechanismsofbone injurythancalciumandvitaminDmalabsorptionarethoughttobeinvolved,suchasproin?ammatorycytokines,parathyroid functionabnormalities,andmisbalancedboneremodelingfactors,mostofallrepresentedbythereceptoractivatorofnuclear factor B/receptor activator of nuclear factor B-ligand/osteoprotegerin system. By means of dual-energy X-ray absorptiometry (DXA),itisnowrapidandeasytoobtainsemiquantitativevaluesofBMD.However,thequestionisstillopenaboutwhoand whensubmittoDXAevaluationinCD,inordertoestimateriskoffractures.Furthermore,additionalinformationontheroleof nutritionalsupplementsandalternativetherapiesisneeded. 1.EpidemiologyofBoneInvolvementinCD ontheprevalenceo