Bone mass and metabolism in patients with celiac disease

Corazza, Gino Roberto; Sario, A. Di; Cecchetti, L.; Tarozzi, C.; Corrao, Giovanni; Bernardi, Mauro; Gasbarrini, Giovanni

doi:10.1016/0016-5085(95)90276-7

Cited by 199 publications

(116 citation statements)

References 36 publications

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“…4,30,31 In the patients with CD who are on GFD, serum calcium levels were higher than the levels of the untreated patients and did not differ from those of healthy children. These findings agree with the previous studies 32,33 and suggest that calcium absorption is normal in patients on GFD. However, in the present study, we observed increased serum levels of iPTH and decreased serum levels of calcium in only 2 of 16 patients with untreated celiacs and there were no other abnormal laboratory tests.…”

Section: Discussionsupporting

confidence: 93%

Bone Mineral Density and Importance of a Gluten-Free Diet in Patients With Celiac Disease in Childhood

Kalaycı

Kansu²,

Girgin³

et al. 2001

Pediatrics

111

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ABSTRACT. Objectives. Celiac disease (CD), a common cause of malabsorption, is known to be associated with disorders of the skeleton, but there are conflicting data about the effect of diet on bone metabolism. The aims of this study were to investigate the prevalence of osteopenia; to identify the relationship between bone mineral density (BMD), serum calcium, and parathyroid hormone levels; and to determine the effect of glutenfree diet on BMD in children with celiac disease.Design. The study included 32 patients with CD (group 1) and 82 healthy controls (group 2). The patients with CD were evaluated under 2 subgroups, ie, 16 patients with recent diagnosis (group 1a) and 16 patients who follow their diet strictly (group 1b). BMD values and concentrations of calcium, phosphorus, alkaline phosphatase, and intact parathyroid hormone were determined on entry to the study and at 12 months in celiac patients. These values were compared with those of healthy control participants.Results. BMD and bone mineral content values in patients with recent diagnosis were found to be significantly lower than the control group. The BMD values in patients with recent diagnosis were significantly increased after a gluten-free diet for 1 year. Osteopenia was found more commonly in patients with recent diagnosis than patients in whom a gluten-free diet had been instituted. At 1-year follow-up, osteopenia was not resolved with the gluten-free diet, and this was especially true in patients without gastrointestinal manifestation. In patients with recent diagnosis (group 1a), the mean calcium level was found to be lower than the patients who follow their diet strictly (group 1b). There was a positive correlation between calcium level and BMD and bone mineral content.Conclusions. BMD is almost invariably low in newly diagnosed celiac patients in childhood. We therefore recommend that BMD should be evaluated in patients with CD. Strict gluten avoidance promoted a significant increase in BMD. However, values still remained markedly low after 1 year of follow-up in some patients. These patients should be followed for longer periods of time with yearly BMD evaluation, as 1 year of diet therapy was found to be insufficient for osteopenia to be resolved. Pediatrics 2001;108(5). URL: http://www. pediatrics.org/cgi/content/full/108/5/e89; bone mineral density, celiac disease, gluten-free diet, osteopenia, osteoporosis, childhood.

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Section: Discussionsupporting

confidence: 93%

Bone Mineral Density and Importance of a Gluten-Free Diet in Patients With Celiac Disease in Childhood

Kalaycı

Kansu²,

Girgin³

et al. 2001

Pediatrics

111

View full text Add to dashboard Cite

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“…Numerous factors have been postulated to effect BMD in celiac disease. For example, celiac disease has been linked to calcium malabsorption with secondary hypersecretion of PTH [6,[34][35][36]. Vitamin D activity is also impaired, with reduced vitamin D dependent transporter protein seen in active celiac disease [37][38][39].…”

Section: Discussionmentioning

confidence: 99%

Long-term Fracture Risk in Patients with Celiac Disease: A Population-Based Study in Olmsted County, Minnesota

et al. 2007

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Celiac disease is associated with decreased bone density, but there are conflicting data regarding fracture risk. We determined the fracture incidence relative to matched controls in a population-based cohort with celiac disease before and after diagnosis. Olmsted County residents with celiac disease (n = 83) diagnosed between 1950 and 2002 were compared with 166 gender and age matched controls. Fracture histories were ascertained from each subject's medical records. Celiac disease is linked to an increased fracture risk before and after diagnosis. Before the index date, cases had a fracture rate twice that of controls (CI: 1.0-3.9, P = 0.045) and 2.5-fold greater after the index date (CI: 1.1-5.6, P = 0.026). Appendicular and axial fractures were 2.5 (CI: 0.9-6.5) and 3.2 times more likely (CI: 1.0-10.5) after the index date. These observations support a rationale for earlier detection of celiac disease, and active management of bone disease before bone effects have occurred, to reduce the persistent risk of fractures.

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“…An increased receptor-associated nuclear factor kappa ligand/osteoprotegerin ratio has been also detected in newly diagnosed patients with CD (41); this dissociation causing uncoupled bone remodelling have been also proved by the elevation of markers of increased bone turnover in CD (42,43). Local factors may affect the bone remodelling in CD as well.…”

Section: Discussionmentioning

confidence: 97%

Does dermatitis herpetiformis result in bone loss as coeliac disease does?: a cross sectional study

Lőrinczy

Juhász

Csontos

et al. 2013

Rev. esp. enferm. dig.

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Introduction and objectives: coeliac disease (CD) and its cutaneous manifestation, dermatitis herpetiformis are both (DH) glutensensitive diseases. Metabolic bone disease is common among patients with CD, even in asymptomatic forms. Data are scarce about bone density in patients with dermatitis herpetiformis. The aim of our study was to compare bone mineral density (BMD) of celiac and dermatitis herpetiformis patients.Methods: 34 coeliac patients, 53 with dermatitis herpetiformis and 42 healthy controls were studied. The mean age was 38.0 ± 12.1, 32.18 ± 14.95, 35.33 ± 10.41 years in CD, dermatitis herpetiformis, and healthy controls, respectively. Bone mineral density of the lumbar spine, the left femoral neck and radius were measured by dual-energy X-ray absorptiometry. Low bone density, osteopenia and osteoporosis were defined as a body mass density (BMD) T-score between 0 and -1, between -1 and -2.5, and under -2.5, respectively.Results: at lumbar region, consisting of dominantly trabecular compartment, a decreased BMD was detected in 49 % (n = 26) patients with dermatitis herpetiformis, 62 % (n = 21) of CD patients, and 29 % (n = 12) of healthy controls, respectively. Lower BMD were measured at the lumbar region in dermatitis herpetiformis and CD compared to healthy subjects (0.993 ± 0.136 g/cm 2 and 0.880 ± 0.155 g/cm 2 vs. 1.056 ± 0.126 g/cm 2 ; p < 0.01). Density of bones consisting of dominantly cortical compartment (femoral neck) did not differ in dermatitis herpetiformis and healthy subjects.Conclusions: our results show that a low bone mass is also frequent among patients with dermatitis herpetiformis. Bone mineral content in these patients is significantly lower in those parts of the skeleton which contain more trabecular than cortical bone.

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Bone mass and metabolism in patients with celiac disease

Cited by 199 publications

References 36 publications

Bone Mineral Density and Importance of a Gluten-Free Diet in Patients With Celiac Disease in Childhood

Bone Mineral Density and Importance of a Gluten-Free Diet in Patients With Celiac Disease in Childhood

Long-term Fracture Risk in Patients with Celiac Disease: A Population-Based Study in Olmsted County, Minnesota

Does dermatitis herpetiformis result in bone loss as coeliac disease does?: a cross sectional study

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