BONE MASS AND METABOLISM IN WHIPPLES-DISEASE - THE ROLE OF HYPOGONADISM

Background: Whipple's disease, like other malabsorption syndromes, oug ht to predispose to osteopenia. We therefore evaluated bone mass and m ineral metabolism in a cohort of patients with this condition. Methods : Twelve male patients with Whipple's disease and 36 male age-matched healthy subjects took part in the study. None of the patients complain ed of diarrhea at the time of the study. Bone mineral density at the l umbar and femoral level and serum levels of indices of bone and minera l metabolism and of gonadal function were measured. Results: Bone mine ral density at the total femur and femoral neck were significantly low er in patients with Whipple's disease than in healthy volunteers, wher eas no significant difference was found at the lumbar level. In patien ts with Whipple's disease serum levels of type-I collagen teleopeptide (ICTP) and sex-hormone-binding globulin were significantly higher, wh ereas serum levels of testosretone and luteinizing hormone were signif icantly lower than in healthy volunteers. Moreover, testosterone corre lated significantly (P < 0.05) with lumbar bone mineral density (r(s) = 0.64) and serum ICTP levels (r(s) = -0.63). Conclusions: In patients with previously treated Whipple's disease and without any current sym ptoms of malabsorption, bone loss is generally moderate and linked to the presence of hypogonadism.