PROPEPTIDE OF TYPE-I PROCOLLAGEN IS PREDICTIVE OF POSTTREATMENT BONE MASS GAIN IN ADULT CELIAC-DISEASE

Background & Aims: Adult celiac disease is associated with osteopenia, which is not always reversible after gluten-free diet (GFD). A prospe ctive study was conducted to evaluate whether pretreatment indices of bone and mineral metabolism are predictive of the extent of bone mass gain after diet. Methods: Lumbar and femoral bone mineral density (z-s core) and serum levels of parathyroid hormone, 1,25-dihydroxycholecalc iferol, COOH-tevminal propeptide of type I procollagen (PICP), and COO H-terminal telopeptide of type I collagen (ICTP) were measured in 20 c eliac patients at diagnosis and after 2 years of GFD. Results: All pat ients showed a posttreatment improvement in bone mass and in serum lev els of indices of bone and mineral metabolism. Nevertheless, only in 1 2 of 20 patients was this improvement at least equal to half the SD of the z-score, which equals a gain of at least 5% in bone mass. Pretrea tment levels of PICP strictly correlated with the increase in lumbar ( r(s) = 0.92; P < 0.001) and femoral z-scores (r(s) = 0.89; P < 0.001). Only in patients with basal PICP above the normal range did the z-sco re increase after GFD by at least half the SD. Conclusions: In adult c eliac disease, a high rate of osteosynthetic activity before treatment is predictive of the satisfactory recovery of bone mass after GFD.