Alterations of Inflammatory and Matrix Production Indices in Celiac Disease With Low Bone Mass on Long-term Gluten-free Diet

M, Di Stefano; Bergonzi, M.; Benedetti, Irene; Amici, Mara De; Torre, Cristina La; Brondino, Natascia; Miceli, Emanuela; Pagani, Elisabetta; Marseglia, Gian Luigi; Corazza, Gino Roberto; Sabatino, Antonio Di

doi:10.1097/mcg.0000000000001032

Cited by 13 publications

(14 citation statements)

References 28 publications

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“…Our findings, in contrast with the majority of the previous literature [34], did not support the idea that low BMD in CeD could depend on vitamin D deficiency and/or low intestinal calcium absorption. Other reasonable candidates could be malnutrition and/or inflammatory mechanisms [35] in accordance with a recent study [36]. In this view, the assessment of the active form of the vitamin D levels in CeD could change the perspective about the existence and the role of vitamin D deficiency in CeD as in other diseases.…”

Section: Discussionmentioning

confidence: 66%

25-Hydroxyvitamin D, 1,25-Dihydroxyvitamin D, and Peripheral Bone Densitometry in Adults with Celiac Disease

et al. 2020

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Background: Adults with celiac disease (CeD) show low bone mineral density (BMD) and high fracture risk. CeD guidelines suggest measurements of serum minerals and vitamin D. However, studies on vitamin levels in CeD patients are contradictory. Aim: To investigate in CeD, 25-hydroxy-vitamin D [25(OH)D], 1,25-dihydroxy-vitamin D [1,25(OH)2D], and related analytes and to evaluate their relationships to peripheral BMD as assessed by peripheral quantitative computed tomography (pQCT). Methods: Gluten-free diet (GFD)-treated, and untreated adult CeD patients naïve to vitamin D and calcium supplementation underwent measurements of serum 25(OH)D, 1,25(OH)2D, parathyroid hormone (PTH), total calcium, phosphate, and of radius BMD by pQCT. Results: Complete data were collected in 105 patients for lab tests and 87 patients for BMD. For lab tests, untreated CeD differed from treated CeD for 22.0% lower serum 25(OH)D (p = 0.023), 42.5% higher serum PTH (p < 0.001), and 13.0% higher serum 1,25(OH)2D (p = 0.029) in the presence of similar serum calcium and phosphorus (p > 0.35). For BMD, untreated CeD differed from treated CeD for lower diaphyseal cortical BMD (1133 and 1157 mg/cm3, p = 0.004) but not for distal BMD (total, trabecular, and subcortical, p > 0.13). Independent correlates of diaphyseal cortical BMD were GFD treatment and body mass index (p < 0.05). Conclusions: Data indicated that, compared to CeD patients on a gluten-free diet, untreated adult CeD patients at diagnosis had lower 25(OH)D, higher PTH, and higher 1,25(OH)2D in the absence of difference in serum calcium and phosphorus. 25(OH)D and 1,25(OH)2D, even below the normal range, were not associated with BMD. Our findings do not support the use of vitamin D supplementation for all CeD adults.

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Section: Discussionmentioning

confidence: 66%

25-Hydroxyvitamin D, 1,25-Dihydroxyvitamin D, and Peripheral Bone Densitometry in Adults with Celiac Disease

et al. 2020

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“…Cause of metabolic disease in celiac is multifactorial, persistent activation of inflammation along with calcium and vitamin D malabsorption is also important cause of metabolic bone disease in these patients. [ 5 6 ]…”

Section: Introductionmentioning

confidence: 99%

Study of effect of gluten-free diet on vitamin D levels and bone mineral density in celiac disease patients

Verma

Lata

Khanna

et al. 2022

J Family Med Prim Care

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Objective: Celiac disease (CD) is a multifactorial immune-mediated enteropathy caused by a response to ingested gluten. The current available treatment for CD is lifelong gluten-free diet (GFD). This study was done to see the effect of GFD on Vitamin D levels and bone mass density in celiac patients. Methods: A prospective interventional study on newly diagnosed celiac patients was conducted in the Pediatrics department of a tertiary care teaching institute in 2 stages viz. on presentation and after 6 months of GFD. Anthropometric measurements, biochemical investigations, Vitamin D levels, and DEXA scan was done at recruitment and after 6 months of GFD and was analyzed. Results: In newly diagnosed 60 pediatric celiac patients, positive effect of GFD on anthropometry, hemoglobin, Vitamin D levels, DEXA scan parameters was observed. Significant difference was found in Vitamin D levels which increased from baseline 14.85 ± 5.39 to 18.22 ± 5.67 ng/ml after 6 months of GFD ( P < 0.05). Significant difference was found in BMD (mean Z-score) which increased from -0.941 ± 0.738 to -0.640 ± 0.60 after 6 months of GFD ( P < 0.001). Conclusion: Our study concluded that there is significant increase in vitamin D levels as well as Z-score, bone mass density (BMD) and bone Mass Content (BMC) after 6 months of GFD.

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“…Therefore, additional factors must be taken into consideration. Firstly, the nutritional adequacy of GFD is critical for suitable treatment and prevention of additional problems derived from the oxidative stress and inflammation promoted by CD [20], which might also be involved in the pathophysiology of metabolic bone disease [7]. It is also essential to ensure that the GFD follows the Mediterranean Diet (MD) because this healthy dietary pattern involves a high content of nutrients that could be important to achieve a healthy musculoskeletal system [21], and it is associated with a rise in BMD and prevention of osteoporosis [22,23].…”

Section: Introductionmentioning

confidence: 99%

“…The origin of metabolic bone disease is multifactorial in CD. In addition to the poor absorption of vitamin D and calcium and the sequestration of calcium and magnesium by unabsorbed fats due to malabsorption, it seems that the persistent activation of inflammation is the leading cause of the pathophysiology of metabolic bone disease [ 7 ]. Deficiencies in some nutrients, such as minerals (calcium, zinc, iron) and vitamins (vitamin D and other fat-soluble vitamins), due to malabsorption processes inherent to this condition are common in untreated CD patients or before diagnosis [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Influence of Mediterranean Diet Adherence and Physical Activity on Bone Health in Celiac Children on a Gluten-Free Diet

et al. 2021

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We aimed to assess the influence of the Mediterranean Diet adherence and physical activity (PA) on body composition, with a particular focus on bone health, in young patients with celiac disease (CD). The CD group (n = 59) included children with CD with a long (>18 months, n = 41) or recent (<18 months, n = 18) adherence to a gluten-free diet (GFD). The non-celiac group (n = 40) included non-celiac children. After adjusting for potential confounders, the CD group showed lower body weight (p = 0.034), lean mass (p = 0.003), bone mineral content (p = 0.006), and bone Z-score (p = 0.036) than non-celiac children, even when the model was further adjusted for adherence to a GFD for at least 18 months. Among CD children, spending greater time in vigorous physical activity was associated with higher lean mass (p = 0.020) and bone mineral density with evidence of statistical significance (p = 0.078) regardless of the time they followed a GFD. In addition, a greater Mediterranean Diet adherence was associated with a higher bone Z-score (p = 0.020). Moreover, lean mass was strongly associated with bone mineral density and independently explained 12% of its variability (p < 0.001). These findings suggest the importance of correctly monitoring lifestyle in children with CD regarding dietary habits and PA levels to improve lean mass and, consequently, bone quality in this population.

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Alterations of Inflammatory and Matrix Production Indices in Celiac Disease With Low Bone Mass on Long-term Gluten-free Diet

Cited by 13 publications

References 28 publications

25-Hydroxyvitamin D, 1,25-Dihydroxyvitamin D, and Peripheral Bone Densitometry in Adults with Celiac Disease

25-Hydroxyvitamin D, 1,25-Dihydroxyvitamin D, and Peripheral Bone Densitometry in Adults with Celiac Disease

Study of effect of gluten-free diet on vitamin D levels and bone mineral density in celiac disease patients

Influence of Mediterranean Diet Adherence and Physical Activity on Bone Health in Celiac Children on a Gluten-Free Diet

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