Influence of pattern of clinical presentation and of gluten-free diet on bone mass and metabolism in adult coeliac disease

Corazza, Gino Roberto; Sario, A. Di; Cecchetti, L.; Jorizzo, Regina Anna; M, Di Stefano; Minguzzi, L.; Brusco, G.; Bernardi, Mauro; Gasbarrini, Giovanni

doi:10.1016/8756-3282(96)00071-3

Cited by 115 publications

(94 citation statements)

References 21 publications

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“…Some studies suggest that people with undetected cluster of differentiation have a tendency towards low bone density (19,20) and mild nutritional deficits (21). Even in our large study, our population with TS and cluster of differentiation was too small to provide sufficient power to address this issue with statistical significance.…”

Section: Discussionmentioning

confidence: 57%

Serological screening for coeliac disease in adults with Turner's syndrome: prevalence and clinical significance of endomysium antibody positivity

Frost¹,

Band²,

Conway³

2009

European Journal of Endocrinology

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Objective: To investigate the prevalence of coeliac disease (CD) in an adult population with Turner's syndrome (TS). Design: A clinic population with TS was screened using a serological test for CD. Methods: Two hundred and fifty six patients with TS were included in the study. Five patients had existing diagnoses of CD. The remaining 251 asymptomatic patients were screened using an IgA endomysium antibody (EMA) test. Positive cases were offered endoscopy with duodenal biopsy. HLA typing was undertaken in existing cases and new EMA-positive cases. Results: Of the 251 patients screened, eight were found to be EMA positive (3.2%). Seven patients proceeded to duodenal biopsy on which all were confirmed histologically to have cluster of differentiation (2.8%). The prevalence of subclinical cluster of differentiation in the population can therefore be estimated between 2.8 and 3.2%. The total population prevalence of CD, including the previously diagnosed cases, is estimated between 4.7 and 5.1%. Ten patients with histologically confirmed cluster of differentiation underwent HLA typing of which eight were HLA-DQ2 positive, one was HLA-DQ8 positive and one was negative to both HLA-DQ2 and HLA-DQ8. Conclusions: This study demonstrates an increased prevalence of cluster of differentiation in an adult population with TS over the general population. This is consistent with previous data published in paediatric populations.

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Section: Discussionmentioning

confidence: 57%

Serological screening for coeliac disease in adults with Turner's syndrome: prevalence and clinical significance of endomysium antibody positivity

Frost¹,

Band²,

Conway³

2009

European Journal of Endocrinology

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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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“…Confusing results on the relationship between GFD and metabolism have been provided: most of studies demonstrated a lower prevalence of low BMD in coeliac patients who are on GDF (16,29), as well as GFD exert a beneficial effect on bone metabolism of coeliac patients (30)(31)(32). A similar prevalence of low BMD have been documented after one (33) and three years (34) on GFD, which shows that the main recovery in bone mass is reached in the first year of following the diet.…”

Section: Discussionmentioning

confidence: 99%

“…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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Influence of pattern of clinical presentation and of gluten-free diet on bone mass and metabolism in adult coeliac disease

Cited by 115 publications

References 21 publications

Serological screening for coeliac disease in adults with Turner's syndrome: prevalence and clinical significance of endomysium antibody positivity

Serological screening for coeliac disease in adults with Turner's syndrome: prevalence and clinical significance of endomysium antibody positivity

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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