Association of homocysteine, vitamin B and bone turnover markers in celiac patients on gluten free diet

Svrha je ovoga rada bila utvrditi povezanost biljega koštane pregradnje s razinom homocisteina i ciljanih vitamina B skupine, te utvrditi kakvoću prehrane i nutritivni status osoba s celijakijom koje su na bezglutenskoj prehrani. Istraživanjem je obuhvaćena 61 osoba s celijakijom (10 muškaraca i 51 žena) u dobi od 18 do 69 godina i 65 zdravih žena s područja Republike Hrvatske. S obzirom na antropometrijske i biokemijske parametre uspoređena je ispitivana skupina (fertilne žene sa celijakijom, N=42) s kontrolnom skupinom (fertilne zdrave žene, N=65). Blago povećana koncentracija homocisteina utvrđena je u 26,2 % žena u ispitivanoj skupini, a prosječna vrijednost homocisteina nije se značajno razlikovala od kontrolne skupine. Utvrđena je statistički značajna negativna korelacija homocisteina s folatom u serumu (r=-0,446), folatom u eritrocitima (r=-0,398) te s vitaminom B12 (r=-0,376). Međutim nije utvrđena povezanost homocisteina s biljezima koštane pregradnje (alkalna fosfataza, osteokalcin i CTx) ni u jednoj od promatranih skupina. Bezglutenska prehrana osoba s celijakijom je neuravnotežena, a za većinu vitamina i mineralnih tvari ispitanici nisu dosegli preporučeni dnevni unos. Odabir obogaćene bezglutenske hrane vitaminima i mineralnim tvarima ili uporaba dodataka prehrani pridonijela bi adekvatnom unosu mikronutrijenata.The aim of this study was to determine correlation between bone turnover markers and homocysteine levels and certain B vitamins. In addition, the aim was to determine the quality of diet and nutritional status of celiac patients adhering gluten free diet. The study included 61 celiac patients age 18–69 and 65 healthy women from the Republic of Croatia. Relating to anthropometrical and biochemical parameters the investigated group (42 fertile women with celiac disease) and the control group (65 healthy fertile women) were compared. Elevated levels of homocysteine (>10 μmol/L) were found in 26.2 % in investigated group; however there was no significant difference between the two groups regarding the average value of homocysteine levels. Significantly negative correlation between homocysteine levels and serum folate (r=-0,446), red blood cell folate (r=-0,398) and vitamin B12 (r=-0,376) was found. There was no correlation between homocysteine levels and bone turnover markers (alkaline phosphatase, osteocalcin and CTx) in any of the observed groups. Gluten free diet of celiac patients is unbalanced and the recommended daily intake for most of the vitamins and minerals was not reached. Gluten free diet enriched in vitamins and minerals or using dietary supplements would contribute to adequate micronutrient intake