Impact of a gluten-free diet on bone mineral density in celiac patients

Kotze, Lorete Maria da Silva; Skare, Thelma Larocca; Vinholi, Antonella; Jurkonis, Leandro Bressianini; Nisihara, Renato

doi:10.17235/reed.2015.3953/2015

Cited by 20 publications

(17 citation statements)

References 25 publications

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“…Other complications related to CD involve bone health, which is closely related to the nutritional status especially of calcium and vitamin D [75]. Impaired bone health is highly prevalent in children and adults at diagnosis of CD, even in individuals with mild enteropathy (without villous atrophy) [43,44,[76][77][78][79][80][81][82][83][84][85]. In adult onset CD, a GFD generally improves but rarely normalizes BMD and the serious impact of this is shown in studies examining fracture risk [51,86].…”

Section: Comorbidities Potentially Related To Nutrient Deficiencies Imentioning

confidence: 99%

Narrative Review: Nutrient Deficiencies in Adults and Children with Treated and Untreated Celiac Disease

et al. 2020

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Nutrient deficiencies are well recognized as secondary consequences of celiac disease (CD) and closely related to the clinical presentation of affected patients. Despite their clinical significance, consensus is lacking on the pattern and frequency of nutrient deficiencies in CD, the usefulness of their assessment at the time of diagnosis and during follow-up. This review aims to provide an overview of nutrient deficiencies among pediatric and adult CD patients at diagnosis and on a gluten-free diet (GFD), and their potential causes in CD. Secondly, we review their impact on CD management strategies including the potential of nutrient supplementation. A search of Medline, Pubmed and Embase until January 2019 was performed. Despite a high variability between the reported deficiencies, we noted that nutrient deficiencies occur frequently in children and adults with CD at diagnosis and during treatment with a GFD. Both inadequate dietary intake and/or diminished uptake due to intestinal dysfunction contribute to nutrient deficiencies. Most deficiencies can be restored with (long-term) treatment with a GFD and/or supplementation. However, some of them persist while others may become even more prominent during GFD. Our results indicate a lack of comprehensive evidence on the clinical efficacy of nutrient supplementation in CD management highlighting the need for further studies.

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Section: Comorbidities Potentially Related To Nutrient Deficiencies Imentioning

confidence: 99%

Narrative Review: Nutrient Deficiencies in Adults and Children with Treated and Untreated Celiac Disease

et al. 2020

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“…Celiac disease (CD) is a chronic enteropathy, characterized by permanent gluten intolerance in genetically predisposed people (1,2) . The disease affects about 1% of the world's population with a predominance of young adults (3,4) .…”

Section: Introductionmentioning

confidence: 99%

Reproductive Aspects in Brazilian Celiac Women

Kotze

Mallmann

Miecznikowski

et al. 2020

Arq. Gastroenterol.

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BACKGROUND: Celiac disease (CD) is a chronic enteropathy in response to ingestion of gluten. CD was associated with gynecological disorders. OBJECTIVE: In this retrospective study, we aimed to investigate the age of menarche, age of menopause, number of pregnancies and abortions in Brazilian celiac patients. METHODS: We studied 214 women diagnosed with CD and as control group 286 women were investigated. RESULTS: Regarding the mean age of menarche, a significant difference was found (12.6±1.40 in CD and 12.8±1.22 years in healthy group; P=0.04). Regarding abortions, in CD women 38/214 (17.8%) and 28/286 (9.8%) in the control group reported abortion (P=0.0092, OR:1.98; CI95%=1.1- 3.3). There was no significant difference in the mean age of menopause nor number of pregnancies per woman. CONCLUSION: In this study, we found that celiac women had a higher mean age of menarche and higher risk of spontaneous abortions.

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“…3 It has been demonstrated that up to 75% of patients with coeliac disease (CD) suffer from bone mass loss (osteopenia or osteoporosis). [4][5][6][7][8][9][10] Despite the strong association between low BMD and CD, guidelines do not express with certainty whether each patient with a new diagnosis of CD should undergo a DEXA scan. [11][12][13] At present, DEXA investigations are suggested only for patients with CD who are peri-or post-menopausal females or males over 55 years and those with overt malabsorption or a history of fragility fractures.…”

Section: Introductionmentioning

confidence: 99%

Risk factors associated with osteoporosis in a cohort of prospectively diagnosed adult coeliac patients

Galli¹,

Lahner²,

Conti³

et al. 2018

UEG Journal

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Background: Up to 75% of patients with untreated coeliac disease (CD) present with osteopenia or osteoporosis. Guidelines do not express with certainty whether each patient with newly diagnosed CD should undergo a dual-energy x-ray absorptiometry (DEXA) scan. Aim: The aim of this article is to evaluate the prevalence of bone mineral density (BMD) alterations at diagnosis and risk factors associated with osteoporosis. Methods: A total of 214 adult patients (median age 38 years; female ¼ 71.5%) newly diagnosed with CD underwent DEXA. The patients were divided into three groups: patients with normal BMD, those with osteopenia and those with osteoporosis. Clinical, histological and serological features were assessed and compared among the three groups. Logistic regression including relevant independent variables was performed. Results: DEXA indicated that 39.7%, 42.5% and 17.8% of the CD patients had normal BMD, osteopenia and osteoporosis, respectively. Logistic regression indicated that features significantly associated with osteoporosis were male gender (OR 4.7; 95%CI 1.1 to 20.8), age !45 years (OR 6.5; 95% CI 1.3 to 32.2), underweight (OR 7.4; 95% CI 1.3 to 42.5) and greater histological damage (Marsh 3C; OR 5.8; 95% CI 1.4 to 24.1). Conclusions: BMD alterations were found in 60.3% of newly diagnosed adult coeliac patients. Osteoporosis was significantly associated with age !45 years, male gender, underweight and Marsh 3C, suggesting that at CD diagnosis, a DEXA scan might be beneficial, particularly in these subgroups of patients. Key summary. Dual-energy x-ray absorptiometry (DEXA) scans have been recommended only for coeliac disease (CD) patients who are peri-or post-menopausal females or males over 55 years and those with overt malabsorption or a history of fragility fractures. . In this study, bone mineral density alterations were found in 60.3% of newly diagnosed adult CD patients.. Osteoporosis was significantly associated with age !45 years, male gender, underweight and Marsh 3C, suggesting that at CD diagnosis, a DEXA scan might be beneficial.

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Impact of a gluten-free diet on bone mineral density in celiac patients

Cited by 20 publications

References 25 publications

Narrative Review: Nutrient Deficiencies in Adults and Children with Treated and Untreated Celiac Disease

Narrative Review: Nutrient Deficiencies in Adults and Children with Treated and Untreated Celiac Disease

Reproductive Aspects in Brazilian Celiac Women

Risk factors associated with osteoporosis in a cohort of prospectively diagnosed adult coeliac patients

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