BACKGROUND & AIMS Guidelines advise measurement of bone mineral density (BMD) in patients with a diagnosis of celiac disease. The lumbar spine (LS) and hip sites are usually measured. Although skeletal sites rich in trabecular bone are believed to be vulnerable to osteoporosis in patients with celiac disease, most studies have not measured the cortical distal 1/3-radius. METHODS We collected data from 721 patients (mean age, 43.6 years; 68.4% female) with celiac disease who underwent 3-site dual energy x-ray absorptiometry (DXA, at a median 1.22 years after diagnosis). We assessed skeletal site- and sex-specific osteoporosis prevalence and the incremental utility of 1/3-radius measurement by DXA. RESULTS Mean T- and Z-scores were normal in patients, but 43.3% had osteopenia and 19.6% had osteoporosis. Osteoporosis was found in 12.1% of patients at the LS, 5.3% of patients at the total hip, 7.6% of patients at the femoral neck, and 11.5% of patients at the 1/3-radius. A greater degree of villous atrophy at diagnosis was associated with male sex and lower T-scores at the 1/3-radius (P = .03), but not other skeletal sites. Isolated forearm osteoporosis was detected in 4.9% of patients. A higher proportion of patients with isolated forearm osteoporosis were male and had a greater weight and body mass index (all P < .01, compared to patients with osteoporosis only at other sites). Z-scores were lower at the LS and 1/3-radius and osteoporosis was more common in men than women. In men, the 1/3-radius was the most frequent site for osteoporosis. Among patients 50 years or older, isolated forearm osteoporosis was present in 10.7%. CONCLUSIONS Based on DXA analysis of patients with celiac disease, the prevalence of osteoporosis appears to be underestimated-particularly in men when BMD at the 1/3-radius is not measured. Degree of villous atrophy is associated with BMD at the 1/3-radius and nearly 5% of patients have osteoporosis limited to that site. Recommendations for osteoporosis screening in patients with celiac disease should include measurement of the distal 1/3-radius in addition to the hip and LS.

中文翻译：

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通过双能X线骨密度仪测量前臂骨密度可增加患有腹腔疾病的男性骨质疏松症的患病率。

背景与目的指南建议对患有腹腔疾病的患者进行骨矿物质密度（BMD）的测量。通常测量腰椎（LS）和髋关节部位。尽管相信患有腹腔疾病的患者的小梁骨丰富的骨骼部位易患骨质疏松症，但大多数研究并未测量皮质远端1/3半径。方法我们收集了721例腹腔疾病患者的数据（平均年龄43.6岁；女性68.4％），他们接受了3位双能X线骨密度仪（DXA，诊断后中位数为1.22年）。我们评估了骨骼部位和性别特异性骨质疏松症的患病率，以及通过DXA测量1/3半径的增量效用。结果患者的平均T分数和Z分数均正常，但骨质疏松症占43.3％，骨质疏松症占19.6％。在12中发现了骨质疏松症。LS的患者为1％，全髋关节的患者为5.3％，股骨颈的患者为7.6％，1/3半径的患者为11.5％。诊断时绒毛萎缩程度更大与男性性别有关，在1/3半径处T分数较低（P = .03），而与其他骨骼部位无关。在4.9％的患者中检出了前臂骨质疏松症。患有前臂骨质疏松症的患者中，男性比例更高，体重和体重指数更高（与其他部位的骨质疏松症患者相比，所有P <0.01）。Z评分在LS和1/3半径处较低，并且男性骨质疏松症比女性更常见。在男性中，1/3半径是骨质疏松症最常见的部位。在50岁或50岁以上的患者中，前臂骨质疏松症的发生率为10.7％。结论基于对乳糜泻患者的DXA分析，骨质疏松的患病率似乎被低估了，尤其是在男性中，未测量1/3半径的BMD。绒毛萎缩程度与1/3半径处的BMD有关，近5％的患者骨质疏松症局限于该部位。对腹腔疾病患者进行骨质疏松症筛查的建议应包括测量髋部和LS之外的远端1/3半径。