{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:39:40Z","timestamp":1760056780389,"version":"build-2065373602"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Endocrinol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Osteopenia and osteoporosis are common complications of celiac disease (CD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Given the inflammatory background of bone disorders, this study aimed to assess the impact of <jats:italic>TNF-\u03b1<\/jats:italic> gene expression and its serum level on bone mineral density (BMD) in individuals with CD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and methods<\/jats:title><jats:p>The study at the start included 70 adults: 51 women and 9 men with CD, and 10 healthy controls: 8 women, 2 men. In the first phase of the study, densitometric measurements of the lumbar spine (L1\u2013L4) and femoral neck (FN) were performed using dual-energy x-ray absorptiometry (DXA) to identify patients with celiac disease and decreased BMD. These patients constituted Group A (CD with osteopenia\/osteoporosis, n = 12). Group B (CD with normal BMD, n = 6), and Group C (healthy controls with normal BMD, n = 6) were matched for sex, age and body mass to patients in group A. In the second phase of the study, <jats:italic>TNF-\u03b1<\/jats:italic> gene expression was quantified using the real-time quantitative PCR (qRT-PCR) method, and serum TNF-\u03b1 levels were measured with an enzyme-linked immunosorbent assay (ELISA). In third phase, statistical analyses were conducted to investigate the correlations between <jats:italic>TNF-\u03b1<\/jats:italic> expression and serum TNF-\u03b1 levels with bone and anthropometric parameters.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No statistically significant differences in <jats:italic>TNF-\u03b1<\/jats:italic> gene expression or TNF-\u03b1 serum levels were found between the groups. In Group A, <jats:italic>TNF-\u03b1<\/jats:italic> expression did not correlate with bone or anthropometric measures. However, in Group B, lower <jats:italic>TNF-\u03b1<\/jats:italic> expression correlated with higher BMI, FN BMD, L1\u2013L4 BMD, and Z-scores. In contrast, healthy controls showed a positive correlation between <jats:italic>TNF-\u03b1<\/jats:italic> expression and BMD, T-score, and Z-score of the FN. There was also no statistically significant correlation between TNF-\u03b1 cytokine concentration, and the parameters studied in groups A and B.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this study, TNF-<jats:italic>\u03b1<\/jats:italic>, both in terms of gene expression and serum level, does not appear to correlate with BMD status in individuals with CD and osteopenia\/osteoporosis. Larger longitudinal studies integrating additional cytokines and signaling pathways are needed to clarify the role of TNF-\u03b1 in bone loss in celiac disease.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fendo.2025.1670590","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T13:26:31Z","timestamp":1760016391000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["TNF-\u03b1 gene expression in relation to TNF-\u03b1 level and bone mineral density in Polish patients with celiac 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