Digestive Diseases and Sciences

, Volume 53, Issue 4, pp 964–971

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

  • Mohammed R. Jafri
  • Charles W. Nordstrom
  • Joseph A. Murray
  • Carol T. Van Dyke
  • Ross A. Dierkhising
  • Alan R. Zinsmeister
  • Lee J. MeltonIII
Original Paper

Abstract

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.

Keywords

Sprue Fractures Osteoporosis Osteomalacia Outcome 

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Mohammed R. Jafri
    • 1
    • 2
  • Charles W. Nordstrom
    • 1
    • 3
  • Joseph A. Murray
    • 2
    • 4
  • Carol T. Van Dyke
    • 2
    • 4
  • Ross A. Dierkhising
    • 2
    • 5
  • Alan R. Zinsmeister
    • 2
    • 5
  • Lee J. MeltonIII
    • 2
    • 6
  1. 1.Department of Internal MedicineMayo Clinic College of MedicineRochesterUSA
  2. 2.Mayo ClinicRochesterUSA
  3. 3.WaukeshaUSA
  4. 4.Division of Gastroenterology and HepatologyMayo ClinicRochesterUSA
  5. 5.Divisions of BiostatisticsMayo Clinic College of MedicineRochesterUSA
  6. 6.Divisions of EpidemiologyMayo Clinic College of MedicineRochesterUSA

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