GENE POLYMORPHISM FOR Α-RECEPTOR OF OESTROGENES AND ALTERATIONS IN BONE MINERAL DENSITY FOR ADULT CELIAC DISEASE PATIENTS

It is well known that osteopenia and osteoporosis are frequently found celiac disease patients presenting classical symptoms of malabsorption1. Osteomalacia cases have also been diagnosed in celiac patients who do not present clinical signs of malabsorption , in patients with latent celiac disease, as well as in first degree relatives of patients with celiac disease who do not suffer from celiac disease themselves. This suggests the presence of different pathogenic mechanisms2. The analysis of genetic polymorphism represents an effective approach for an in-depth screening of genes potentially implicated in the development of osteoporosis. Because of the central role that estrogen plays in bone metabolism, ER genes play an important role in the determination of bone mineral density and the risk of osteoporosis. The fact that osteoporotic phenotypes are observed in patients with a destructive mutation of the α receptor gene for estrogen together with the signs of reduced bone mineral density that are found in mice presenting a functional insufficiency of ER α, but not in mice showing reduced ER β function, demonstrates that ER α is one of the principal genes involved in the genesis of osteoporosis3. Previously , two intronic polymorphisms of the α ER gene, identified by restriction endonucleases PvuII and TA Xba and repetitive polymorphism sequences, have been linked to bone mass density in the Japanese population and in menopausal Italian women4

EVALUATION OF SECONDARY OSTEOPOROSIS WITH BONE MINERAL DENSITOMETRY AND BONE TURNOVER MARKERS

Osteoporosis is as a very complex multi-factorial pathogenesis; thereby any doctor facing a case of osteoporosis must be very careful. Diagnostic procedures are complex and include careful monitoring of the history of patient, physical examination and some laboratory analysis. In this study, 201 patients aged between 50 and 95 years were selected from 4872 patients consulting orthopedic clinics. This group (201 patients: 168 women, 33 men) showed evidence of osteoporosis: BMD DXA with reduced bone mineral density,T-score: greater than -2.5 SD, or X-ray signs of non traumatic fractures. Patients also underwent biochemical and instrumental investigations for an assessment of bone metabolism. Age, gender, medical history as well as tests of rheumatic metabolism, calcium-phosphorus and some indices of bone turnover were determined for each patient. Interestingly, our data showed that 104 patients had a vertebral fracture without trauma, 22 hypothyroid patients were undergoing treatment with levothyroxine, 3 patients were suffering from autoimmune thyroiditis, 3 patients were suffering from secondary hyperparathyroidism with vitamin D deficiency, 2 patients were suffering from adenoma with primary hyperparathyroidism, 20 were diabetic patients, 7 patients had monoclonal gammopathy, 7 women had hystero- ovario salpingectomy, 7 patients were HCV positive, 4 patients with rheumatoid arthritis had been treated with corticosteroids, 2 patients were suffering from multiple myeloma, and 1 patient had Crohn's disease. There was also 1 suspected case of ulcerative colitis, 5 patients were suffering from celiac disease and other cases described in the paper. As a result of this diverse association, the approach to treating osteoporotic patients should be then accurate and multidisciplinary. It is then important to perform laboratory tests and investigations for correct diagnosis and adequate treatment

EVALUATION OF SECONDARY OSTEOPOROSIS WITH BONE MINERAL DENSITOMETRY AND BONE TURNOVER MARKERS

Osteoporosis is as a very complex multi-factorial pathogenesis; thereby any doctor facing a case of osteoporosis must be very careful. Diagnostic procedures are complex and include careful monitoring of the history of patient, physical examination and some laboratory analysis. In this study, 201 patients aged between 50 and 95 years were selected from 4872 patients consulting orthopedic clinics. This group (201 patients: 168 women, 33 men) showed evidence of osteoporosis: BMD DXA with reduced bone mineral density,T-score: greater than -2.5 SD, or X-ray signs of non traumatic fractures. Patients also underwent biochemical and instrumental investigations for an assessment of bone metabolism. Age, gender, medical history as well as tests of rheumatic metabolism, calcium-phosphorus and some indices of bone turnover were determined for each patient. Interestingly, our data showed that 104 patients had a vertebral fracture without trauma, 22 hypothyroid patients were undergoing treatment with levothyroxine, 3 patients were suffering from autoimmune thyroiditis, 3 patients were suffering from secondary hyperparathyroidism with vitamin D deficiency, 2 patients were suffering from adenoma with primary hyperparathyroidism, 20 were diabetic patients, 7 patients had monoclonal gammopathy, 7 women had hystero- ovario salpingectomy, 7 patients were HCV positive, 4 patients with rheumatoid arthritis had been treated with corticosteroids, 2 patients were suffering from multiple myeloma, and 1 patient had Crohn's disease. There was also 1 suspected case of ulcerative colitis, 5 patients were suffering from celiac disease and other cases described in the paper. As a result of this diverse association, the approach to treating osteoporotic patients should be then accurate and multidisciplinary. It is then important to perform laboratory tests and investigations for correct diagnosis and adequate treatment