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    New Research Identifies Lifestyle Factors Linked to Bone Loss in Celiac Disease


    Scott Adams


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    Eur J Gastroenterol Hepatol 2000;12:1195-1199.

    Celiac.com 01/20/2001 - Italian researchers have identified several key factors that contribute to bone loss in adults with celiac disease, including the following:

    • Gender
    • Malnutrition
    • Disease Severity
    • Physical Activity

    They also conclude that, contrary to current belief, age at diagnosis, sunlight exposure and smoking do not seem to be significant factors in bone mineral density. In their study, Dr. Gino Roberto Corazza (University of Pavia) and associates evaluated 39 adults with untreated celiac disease, including 18 who had symptoms and 21 who did not. The researchers used dual-energy X-ray absorptiometry to measure lumbar spine and femoral neck bone mineral density, and assessed the patients physical activity, cigarette smoking, nutritional status and exposure to sunlight.

    The results of the study indicate that femoral and lumbar bone mineral density was lower in patients with symptoms than patients without, and women tended to have lower mineral bone density than men. This finding, in combination with other factors were associated with reduced bone mineral density in the femoral neck, lumbar spine or both. Further, the key factors seem to be the severity of the patients symptoms and their nutritional status, both of which had significant effects on both lumbar and femoral bone mineral density. The patients levels of physical activity affected only femoral bone mineral density, and the gender of the patient affected mainly the lumbar density.

    This is one of the first studies of its kind, and Dr. Corazzas group stresses the need for follow-up studies to determine whether additional therapeutic measures such as moderate and on-going physical activity and a more rapid implementation of a gluten-free diet might be useful in increasing the bone mass gain in people with celiac disease.

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  • About Me

    In 1994 I was diagnosed with celiac disease, which led me to create Celiac.com in 1995. I created this site for a single purpose: To help as many people as possible with celiac disease get diagnosed so they can begin to live happy, healthy gluten-free lives. Celiac.com was the first site on the Internet dedicated solely to celiac disease. In 1998 I founded The Gluten-Free Mall, Your Special Diet Superstore!, and I am the co-author of the book Cereal Killers, and founder and publisher of Journal of Gluten Sensitivity.

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  • Related Articles

    Scott Adams
    Celiac.com 06/25/2003 - The following is an abstract of a recent study published in the June edition of the Journal of Association of Physicians of India by Dr. Y.A. Gokhale and colleagues from the Lokmanya Tilak Medical College and General Hospital, Mumbai (Bombay). The researchers conclude that symptomatic osteoporotic patients, especially those with associated anemia, who are younger than 55 years of age should be screened for celiac disease. Here is the abstract:


    Celiac Disease in Osteoporotic Indians
    YA Gokhale, PD Sawant, CM Chodankar, ND Desai, MV Patil, S Maroli, MN
    Patil, NK Hase
    J Assoc Physicians India June 2003;51:579-584 Abstract:

    Objective: The aim of the study was to identify the atypical celiac disease (celiac disease) in a cohort of symptomatic osteoporotic patients, younger than 55 years of age and 2) To study associated clinical and laboratory features and outcome with gluten-free diet.
    Material and Methods: We studied 33 patients (F:M =28:5),mean age 29 years (range 15-52 years) with osteoporosis (WHO diagnostic criteria, T-score less than -2.5 on DEXA scan) from January 2000-June 2002. Serological screening for celiac disease was done by detecting circulating IgA antibodies to tissue transglutaminase by ELISA. Patients with presence of antibodies to transglutaminase were subjected to biopsy from the 2nd part of the duodenum by upper GI endoscopy. The biopsies were reported independently by two pathologists who were blinded for the serology report. Measurement of mucosal thickness, crypts and villi were done with an ocular micrometer. Other parameters like complete hemogram, serum iron, total iron binding capacity (TIBC),calcium profile,25-OH-D, parathyroid hormone (PTH) were evaluated. Assessment of clinical and laboratory parameters was performed within 4-12 weeks of starting gluten-free diet (GFD).
    Results: Thirteen patients had circulating IgA antibodies to transglutaminase. Intestinal biopsies were performed on 11 patients and were consistent with the diagnosis of celiac disease (total villous atrophy -two, subtotal villous atrophy with crypt hyperplasia -nine). Patients with celiac disease had significant anemia when compared with non-celiac disease osteoporotic patients. Other important observations in these 11 patients were low serum calcium and phosphorus, low 25-OH-D, high PTH. Significant improvement in clinical and laboratory parameters was noted in all patients within 6-12 weeks of starting GFD.
    Conclusion: Symptomatic osteoporotic patients (younger than 55 years of age) especially with associated anemia should be investigated for celiac disease. Simple measures like omission of wheat from diet (GFD) lead to significant improvement in symptoms within weeks.

    Scott Adams
    Arch Intern Med. 2005;165:370-372, 393-399
    Celiac.com 03/09/2005 - According to a new study by researchers at Washington University School of Medicine in St. Louis, Missouri, everyone with osteoporosis should also be screened for celiac disease. The study looked at 840 people—266 with osteoporosis and 574 without—who were screened for celiac disease using serum anti-tissue transglutaminase (tTG) and anti-endomysial (EMA) antibodies—those who tested positive for either were given a follow-up biopsy. The serological screening results indicated that 12 (4.5%) of the 266 osteoporotic patients were positive for celiac disease, while only six (1.0%) of the 574 non-osteoporotic patients tested positive. Out of the osteoporotic patients who were positive, 3.4% were confirmed by a biopsy, while only 0.2% of the non-osteoporotic patients were confirmed via biopsy (2 of the serological positive group refused a follow-up biopsy). In the group with both celiac disease and osteoporosis, the researchers found a direct correlation between the severity of both diseases, and the treatment of these patients via a gluten-free diet dramatically improved the symptoms of both diseases.
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    Jefferson Adams
    Celiac.com 11/05/2009 - It's well known that people with celiac disease often show reduced bone mineral density, and that metabolic bone disease is a significant and common complication of celiac disease. A new article in the journal Nutrition Reviews reinforces the benefits of a gluten-free diet in reducing bone problems in children with celiac disease.
    This is important information, because, even though celiac disease can be diagnosed at any age, it most often discovered in children between 9 and 24 months of age.
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    Source:
    Nutrition Reviews


    Jefferson Adams
    Celiac.com 06/15/2015 - It's well-documented that people with active celiac disease are more likely to have osteoporosis and increased risk of fractures. High-resolution peripheral quantitative computed tomography (HR-pQCT) allows for three-dimensional exploration of bone micro-architecture, including measurement of cortical and trabecular compartments, and providing detailed information on bone disease pathophysiology and fracture. Using HR-pQCT, research team recently set out to assess the volumetric and micro-architectural characteristics of peripheral bones. that is the distal radius and tibia, in adult pre-menopausal women with active freshly diagnosed celiac disease.
    The research team included María Belén Zanchetta, Florencia Costa, Vanesa Longobardi, Gabriela Longarini, Roberto Martín Mazure, María Laura Moreno, Horacio Vázquez, Fernando Silveira, Sonia Niveloni, Edgardo Smecuol, María de la Paz Temprano, Hui Jer Hwang, Andrea González, Eduardo César Mauriño, Cesar Bogado, Jose R. Zanchetta, an dJulio César Bai. They are variously affiliated with the IDIM, Instituto de Diagnóstico e Investigaciones Metabólicas, and with the Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina.
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    HR-pQCT revealed that most bone micro-architecture parameters were substantially reduced in celiac disease patients compared to a control group. Twenty-two patients showed symptomatic celiac disease. These patients had a greater bone micro-architectural deficit than those with sub-clinical celiac disease.
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    The researchers are looking to conduct a follow-up of this group of patients. They want to know whether bone micro-architecture recovers with a gluten-free diet, and, if so, how quickly and to what extent.
    Source:
    BONE July 2015, Volume 76, Pages 149–157. DOI: http://dx.doi.org/10.1016/j.bone.2015.03.005

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    Jefferson Adams
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    Roxanne Bracknell
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    Jefferson Adams
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    Jefferson Adams
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    Source:
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