Prevalence and predictors of abnormal bone mineral metabolism in recently diagnosed adult celiac patients
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Background and Aims
This study aimed to evaluate the prevalence of low bone mineral density (BMD) in recently diagnosed adult celiac patients and to identify the factors associated with this.
We investigated 54 newly diagnosed adult celiac patients between February 2008 and April 2009. BMD was measured in all patients and its correlation with clinical and biochemical parameters was analyzed.
Fifty-four (24 male) newly diagnosed celiac patients with a mean±SD age of 30.6 ± 9.3 years (range 18–50) were included. Thirty-nine (72.2 %) presented with intestinal symptoms, and the rest with extraintestinal symptoms. Low vitamin D levels were seen in 11 (20.3 %) patients and elevated iPTH (secondary hyperparathyroidism) in 12 (22.2 %) patients. Twenty-one (39 %) patients had normal BMD, 23 (43 %) had osteopenia (T-score −1 to −2.5), and 10 (18 %) patients had osteoporosis (T-score <−2.5). A statistically significant association was seen between BMD and age of onset, duration of illness, serum tTGA levels, serum vitamin D levels, and histopathological changes.
Low BMD is common in newly diagnosed adult celiac patients with approximately one fifth of them having osteoporosis. BMD should be measured in all newly diagnosed celiac patients and calcium and vitamin D supplementation included in the treatment regimen.
- Sollid LM. Coeliac disease: dissecting a complex inflammatory disorder. Nat Rev Immunol. 2002;2:647–55. CrossRef
- Green PH, Jabri B. Coeliac disease. Lancet. 2003;362:383–91. CrossRef
- Pare P, Douville P, Caron D, Lagace R. Adult celiac sprue: changes in the pattern of clinical recognition. J Clin Gastroenterol. 1988;10:395–400. CrossRef
- Campbell CB, Roberts RK, Cowen AE. The changing clinical presentation of coeliac disease in adults. Med J Aust. 1977;1:89–93.
- Green PH. The many faces of celiac disease: clinical presentation of celiac disease in the adult population. Gastroenterology. 2005;128:S74–8. CrossRef
- Murray JA, Van Dyke C, Plevak MF, Dierkhising RA, Zinsmeister AR, Melton LJ. Trends in the incidence and clinical features of celiac disease in a North American community, 1950–2001. Clin Gastroenterol Hepatol. 2003;1:19–27. CrossRef
- Pistorius LR, Sweidan WH, Purdie DW, et al. Celiac disease and bone mineral density in adult female patients. Gut. 1995;37:639–42. CrossRef
- Bernstein CN, Leslie WD, Leboff MS. AGA technical review on osteoporosis in gastrointestinal diseases. Gastroenterology. 2003;124:795–841. CrossRef
- Meyer D, Stavropolous S, Diamond B, Shane E, Green PH. Osteoporosis in a north American adult population with celiac disease. Am J Gastroenterol. 2001;96:112–9.
- Kemppainen T, Kroger H, Janatuinen F, et al. Osteoporosis in adult patients with celiac disease. Bone. 1999;24:249–55. CrossRef
- Marsh MN. Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity (‘celiac sprue’). Gastroenterology. 1992;102:330–54.
- Oberhuber G, Granditsch G, Vogelsang H. The histopathology of coeliac disease: time for a standardized report scheme for pathologists. Eur J Gastroenterol Hepatol. 1999;11:1185–94. CrossRef
- World Health Organisation. Geneva Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. WHO Tech Rep Ser. 1994;843:1–129.
- Walters JRF. Bone mineral density in coeliac disease. Gut. 1994;35:150–1. CrossRef
- Sategna-Guidetti C, Grosso SB, Grosso S, et al. The effects of 1-year gluten withdrawal on bone mass, bone metabolism and nutritional status in newly-diagnosed adult coeliac disease patients. Aliment Pharmacol Ther. 2000;14:35–43. CrossRef
- Jones S, D’Souza C, Haboubi NY. Patterns of clinical presentation of adult coeliac disease in a rural setting. Nutr J. 2006;5:24. CrossRef
- Gokhale YA, Sawant PD, Chodankar CM, et al. Celiac disease in osteoporotic Indians. J Assoc Physicians India. 2003;51:579–83.
- Mautalen C, González D, Mazure R, et al. Effect of treatment on bone mass, mineral metabolism, and body composition in untreated celiac disease patients. Am J Gastroenterol. 1997;92:313–8.
- Corazza GR, Sario AD, Cecchetti L, et al. Influence of clinical presentation and gluten free diet on bone mass and metabolism in adult coeliac disease. Bone. 1996;18:525–30. CrossRef
- Lindh E, Ljunghall S, Larsson K, Lavo B. Screening for antibodies against gliadin in patients with osteoporosis. J Int Med. 1992;231:403–6. CrossRef
- Molteni N, Caraceni MP, Bardella MT, Ortolani S, Gandolini GG, Bianchi PA. Bone mineral density in adult celiac patients and the effect of gluten free diet from childhood. Am J Gastroenterol. 1990;85:51–3.
- Stenson WF, Newberry R, Lorenz R, Baldus C, Civitelli R. Increased prevalence of celiac disease and need for routine screening among patients with osteoporosis. Arch Intern Med. 2005;165:393–9. CrossRef
- Agardh D, Björck S, Agardh CD, Lidfeldt J. Coeliac disease-specific tissue transglutaminase autoantibodies are associated with osteoporosis and related fractures in middle-aged women. Scand J Gastroenterol. 2009;44:571–8. CrossRef
- Dipper CR, Maitra S, Thomas R, Lamb CA. Anti-tissue transglutaminase antibodies in the follow-up of adult coeliac disease. Aliment Pharmacol Ther. 2009;30:236–44. CrossRef
- Tau C, Mautalen C, Rosa DS, Roca A, Valenzuela X. Bone mineral density in children with celiac disease. Effect of a gluten-free diet. Eur J Clin Nutr. 2006;60:358–63. CrossRef
- Malamut G, Matysiak-Budnik T, Grosdider E, et al. Adult celiac disease with severe or partial villous atrophy: a comparative study. Gastroenterol Clin Biol. 2008;32:236–42. CrossRef
- Vitenskap MO. Bone metabolism in patients with newly diagnosed caeliac disease. Beinmetabolisme hos nydiagnostiserte cøliakipasienter. Tidsskr Nor Lægeforen. 2006;126:1201–4.
- Valdimarsson T, Toss G, Löfman O, Ström M. Three years follow-up of bone density in adult coeliac disease: significance of secondary hyperparathyroidism. Scand J Gastroenterol. 2000;35:274–80. CrossRef
- Keaveny AP, Freaney R, Mc Kenna MJ, et al. Bone remodeling indices and secondary hyperparathyroidism in celiac disease. Am J Gastroenterol. 1996;91:1226–31.
- Prevalence and predictors of abnormal bone mineral metabolism in recently diagnosed adult celiac patients
Indian Journal of Gastroenterology
Volume 31, Issue 4 , pp 165-170
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Adult celiac disease
- Bone mineral density
- Celiac disease
- Author Affiliations
- 1. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India
- 2. Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India
- 3. Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India