Coeliac disease and the risk of fractures – a general population‐based cohort study

Ludvigsson, Jonas F.; Michaëlsson, Karl; Ekbom, Anders; Montgomery, Scott

doi:10.1111/j.1365-2036.2006.03203.x

Cited by 161 publications

(131 citation statements)

References 50 publications

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“…This risk is greater than that reported in a study from England [47], while it is similar to the risk of first hip fractures in Swedish children with celiac disease [48]. In this population-based study, we demonstrate that fracture risk is, in fact, elevated among patients with celiac disease.…”

Section: Discussionsupporting

confidence: 65%

“…Most significantly, the increase in fracture risk persists after the diagnosis of celiac disease. This suggests the bone disease at diagnosis is often sufficiently advanced as to preclude a return to health even with subsequent diet restriction and medical management [47][48][49]. It is also possible that the persistent risk of fractures is due to other factors such as muscle weakness or neurologic disturbance, though that would not necessarily explain the trend for increased frequencies of spontaneous and axial fractures in the celiac cases.…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionsupporting

confidence: 65%

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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“…CD is associated with an increased risk of fractures, [154][155][156] with relative risks of around 2 for fractures after CD diagnosis. An earlier study found a similar relationship (odds ratio around 2) for fractures prior to diagnosis, in patients with CD.…”

Section: Qol Aspects Of Screening For CDmentioning

confidence: 99%

Screening for celiac disease in the general population and in high‐risk groups

et al. 2015

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Background: Celiac disease (CD) occurs in approximately 1% of the Western population. It is a lifelong disorder that is associated with impaired quality of life (QOL) and an excessive risk of comorbidity and death. Objectives: To review the literature on screening for CD in relation to the current World Health Organization (WHO) criteria for mass screening. Methods: We performed a PubMed search to identify indexed papers on CD screening with a publication date from 1900 until 1 June 2014. When we deemed an abstract relevant, we read the corresponding paper in detail. Results: CD fulfills several WHO criteria for mass screening (high prevalence, available treatment and difficult clinical detection), but it has not yet been established that treatment of asymptomatic CD may reduce the excessive risk of severe complications, leading to higher QOL nor that it is cost-effective. Conclusions: Current evidence is not sufficient to support mass screening for CD, but active case-finding may be appropriate, as we recognize that most patients with CD will still be missed by this strategy. Although proof of benefit is still lacking, screening for CD may be appropriate in high-risk groups.

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“…Moreover, CD associates with metabolic bone disease. The frequency of low bone mineral density (BMD) among coeliac patients varies widely between different studies due to differences in diagnostic criteria, geographical distribution and patient selection (12)(13)(14). The presence of significant malabsorption leads to a more severe bone loss in CD (15), although BMD is lower in asymptomatic patients compared to healthy subjects, as well (16).…”

Section: K Lorinczy Et Al Rev Esp Enferm Dig (Madrid)mentioning

confidence: 99%

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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Coeliac disease and the risk of fractures – a general population‐based cohort study

Abstract: SUMMARY BackgroundEarlier studies have suggested that untreated coeliac disease may be associated with osteoporosis, but results are contradictory for the risk of long-term fractures.

Cited by 161 publications

References 50 publications

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

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

Screening for celiac disease in the general population and in high‐risk groups

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

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