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Bone and Celiac Disease

  • Secondary Causes of Osteoporosis (SJ Warden, Section Editor)
  • Published:
Current Osteoporosis Reports Aims and scope Submit manuscript

Abstract

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.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Ludvigsson J, Leffler D, Bai JC, Biagi F, Fasano A, Green P, et al. The Oslo definitions for coeliac disease and related terms. Gut. 2013;62:43–52.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Ludvigsson J, Bai JC, Biagi F, Card TR, Ciacci C, Ciclitira PJ, et al. Diagnosis and management of adult coeliac disease: guidelines from the British Society of Gastroenterology. Gut. 2014;63:1210–28.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Pintos Sanchez M, Premysl B, Verdu E, Bai JC. Extraintestinal manifestations of celiac disease. Dig Dis. 2015;33:147–54. Clear summary of all extraintestinal manifestations of celiac disease including bone health.

    Article  Google Scholar 

  4. Green PH, Cellier C. Celiac disease. N Engl J Med. 2007;357(17):1731–43.

    Article  CAS  PubMed  Google Scholar 

  5. Rampertab SD, Pooran N, Brar P, et al. Trends in the presentation of celiac disease. Am J Med. 2006;119:355.e9–e14.

    Article  Google Scholar 

  6. Plugis NM, Khosla C. Therapeutic approaches for celiac disease. Best Pract Res Clin Gastroenterol. 2015;29:503–21.

    Article  CAS  PubMed  Google Scholar 

  7. Corazza G, Di Stefano M, Mauriño E, Bai JC. Bones in coeliac disease: diagnosis and treatment. Best Pract Res Clin Gastroenterol. 2005;19:453–65.

    Article  PubMed  Google Scholar 

  8. Xing Y, Morgan SL. Celiac disease and metabolic bone disease. J Clin Densitom: Assess Manag Musculoskelet Health. 2013;16(4):439–44.

    Article  Google Scholar 

  9. Fornari C, Pedreira S, Niveloni S, González D, Diez R, Vázquez H, et al. Pre- and post-treatment serum levels of cytokines IL-1β, IL-6, and IL-1 receptor antagonist in celiac disease. Are they related to the associated osteopenia? Am J Gastroenterol. 1998;93(3):413–8.

    Article  CAS  PubMed  Google Scholar 

  10. Sugai E, Cherñasky A, Pedreira S, Smecuol E, Vázquez H, Mazure R, et al. Bone specific antibodies in sera from patients with celiac disease. Characterization and implications in osteoporosis. J Clin Inmmunol. 2002;22:353–62.

    Article  CAS  Google Scholar 

  11. Larussa T, Suraci E, Nazionale I, et al. Bone mineralization in celiac disease. Gastroenterol Res Pract 2012:1980–25.

  12. González D, Mazure R, Mautalen C, Vazquez H, Bai JC. Body composition and bone mineral density in untreated and treated patients with celiac disease. Bone. 1995;16:231–4.

    Article  PubMed  Google Scholar 

  13. Ferretti J, Mazure R, Tanoue P, et al. Analysis of the structure and strength of bones inceliac disease patients. Am J Gastroenterol. 2003;98:382–90.

    Article  PubMed  Google Scholar 

  14. Duerksen DR, Leslie WD. Longitudinal evaluation of bone mineral density and body composition in patients with positive celiac serology. J Clin Densitom: Assess Skelet Health. 2011;14(4):478–83.

    Article  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 

  16. Boutroy S, Bouxsein M, Munoz F, Delmas P. In vivo assessment of trabecular bone microarchitecture by high-resolution peripheral quantitative computed tomography. J Clin Endocrinol Metab. 2005;90:6508–15.

    Article  CAS  PubMed  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.

    Article  PubMed  Google Scholar 

  18. Stein EM, Rogers H, Leib A, McMahon DJ, Young P, Nishiyama K, et al. Abnormal skeletal strength and microarchitecture in women with celiac disease. J Clin Endocrinol Metab. 2015;100:2347–53.

    Article  CAS  PubMed  Google Scholar 

  19. Kanis JA, Oden A, Johnell O, De Laet C, Jonsson B, Oglesby AK. The components of excess mortality after hip fracture. Bone. 2003;32(5):468–73.

    Article  CAS  PubMed  Google Scholar 

  20. Vasquez H, Mazure R, Gonzalez D, Flores D, Pedreira S, Niveloni S, et al. Risk of fractures in celiac disease patients: a cross-sectional, case–control study. Am J Gastroenterol. 2000;95:183–9.

    Article  CAS  PubMed  Google Scholar 

  21. Olmos M, Antelo M, Vazquez H, Smecuol E, Mauriño E, Bai JC. Systematic review and meta-analysis of observational studies on the prevalence of fractures in coeliac disease. Dig Liver Dis. 2008;40:46–53.

    Article  CAS  PubMed  Google Scholar 

  22. Heikkilä K, Pearce J, Mäki M, Kaukinen K. Celiac disease and bone fractures: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2015;100(1):25–3.

    Article  PubMed  Google Scholar 

  23. Moreno ML, Vazquez H, Mazure R, Smecuol E, Niveloni S, Pedreira S, et al. Stratification of bone fracture risk in patients with celiac disease. Clin Gastroenterol Hepatol. 2004;2:127–34.

    Article  PubMed  Google Scholar 

  24. Pinto Sánchez MI, Mohaidle A, Baistrocchi A, et al. Risk of fracture in celiac disease: gender, dietary compliance, or both? World J Gastroenterol. 2011;17:3035–42.

    Article  Google Scholar 

  25. American Gastroenterological Association. American gastroenterological association medical position statement: guidelines on osteoporosis in gastrointestinal diseases. Gastroenterology. 2003;124:791–4.

    Article  Google Scholar 

  26. Fouda MA, Khan AA, Sultan MS, Rios LP, McAssey K, Armstrong D. Evaluation and management of skeletal health in celiac disease: position statement. Can J Gastroenterol. 2012;26:819–29.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Holick MF, Binkley NC, Bischoff-Ferrari HA, Gordon CM, Hanley DA, Heaney RP, et al. Endocrine Society. Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2011;96(7):1911–30.

    Article  CAS  PubMed  Google Scholar 

  28. Edwards MH, Dennison EM, Aihie Sayer A, Fielding R. Cooper C osteoporosis and sarcopenia in older age. Bone. 2015;80:126–30.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Susana Carballo for editing the English language of the manuscript.

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Authors and Affiliations

  1. IDIM, Instituto de Diagnóstico e Investigaciones Metabólicas, Libertad 836, (1012), Buenos Aires, Argentina

    María Belén Zanchetta & Vanesa Longobardi

  2. Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina

    María Belén Zanchetta & Vanesa Longobardi

  3. Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología ¨Dr. C. Bonorino Udaondo¨ and Cátedra de Gastroenterología Facultad de Medicina, Universidad del Salvador, Buenos Aires, Argentina

    Julio César Bai

Authors
  1. María Belén Zanchetta
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  2. Vanesa Longobardi
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  3. Julio César Bai
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Corresponding author

Correspondence to María Belén Zanchetta.

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Conflict of Interest

María Belén Zanchetta, Vanesa Longobardi, and Julio César Bai declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

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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This article is part of the Topical Collection on Secondary Causes of Osteoporosis

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Zanchetta, M.B., Longobardi, V. & Bai, J.C. Bone and Celiac Disease. Curr Osteoporos Rep 14, 43–48 (2016). https://doi.org/10.1007/s11914-016-0304-5

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  • DOI: https://doi.org/10.1007/s11914-016-0304-5

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