Bone and Celiac Disease
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More than 50 % of untreated patients with celiac disease (CD) have bone loss detected by bone densitometry (dual-energy X-ray absorptiometry:DXA). Moreover, patients with CD are more likely to have osteoporosis and fragility fractures, especially of the distal radius. Although still controversial, we recommend DXA screening in all celiac disease patients, particularly in those with symptomatic CD at diagnosis and in those who present risk factors for fracture such as older age, menopausal status, previous fracture history, and familial hip fracture history. Bone microarchitecture, especially the trabecular network, may be deteriorated, explaining the higher fracture risk in these patients. Adequate calcium and vitamin D supplementation are also recommended to optimize bone recovery, especially during the first years of gluten free diet (GFD). If higher fracture risk persists after 1 or 2 years of GFD, specific osteoactive treatment may be necessary to improve bone health.
KeywordsCeliac disease Bone disorders Gluten-free diet Bone microarchitecture HRp-QCT Osteoporosis Fractures
We thank Susana Carballo for editing the English language of the manuscript.
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Conflict of Interest
María Belén Zanchetta, Vanesa Longobardi, and Julio César Bai declare that they have no conflict of interest.
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All studies by authors involving animal and/or human subjects were performed after approval by the appropriate institutional review boards. When required, written informed consent was obtained from all participants.
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- 11.Larussa T, Suraci E, Nazionale I, et al. Bone mineralization in celiac disease. Gastroenterol Res Pract 2012:1980–25.Google Scholar
- 15.••Rios LP, Khan A, Sultan M, McAssey K, Fouda MA, Armstrong D. Canadian. Approach to diagnosing celiac disease in patients with low bone mineral density or fragility fractures. Multidisciplinary task force report. Can Fam Phys. 2013;59:1055–61. Practical and useful clinical guideline for bone approach in CD patients.Google Scholar
- 17.••Zanchetta MB, Costa F, Longobardi V, Longarini G, Mazure RM, Moreno ML, et al. Significant bone microarchitecture impairment in premenopausal women with active celiac disease. Bone. 2015;76:149–57. First evidence of an important bone microarchitecture impairment in premenopausal women with CD at diagnosis.CrossRefPubMedGoogle Scholar