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  • Jefferson Adams
    Jefferson Adams

    Premenopausal Women with Active Celiac Disease Show Significant Bone Impairment

    Reviewed and edited by a celiac disease expert.

    Celiac.com 10/26/2015 - Patients with active celiac disease are more likely to have osteoporosis and a higher risk of bone fractures. High-resolution peripheral quantitative computed tomography (HR-pQCT) permits three-dimensional exploration of bone micro-architectural characteristics measuring separately cortical and trabecular compartments, and gives a more profound insight into bone disease pathophysiology and fracture.

    Photo: CC--Seattle Municipal ArchiveA research team recently assessed the volumetric and micro-architectural aspects of peripheral bones-distal radius and tibia-in an adult premenopausal cohort with active celiac disease assessed at diagnosis. The research team included MB Zanchetta, F Costa, V Longobardi, G Longarini, RM Mazure, ML Moreno, H Vázquez, F Silveira, S Niveloni, E Smecuol, MdeL Temprano, HJ Hwang, A González, EC Mauriño, C Bogado, JR Zanchetta, and JC Bai. They are variously affiliated with IDIM, Instituto de Diagnóstico e Investigaciones Metabólicas, Buenos Aires, Argentina, the Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo", Buenos Aires, Argentina; and the Cátedra de Gastroenterología Facultad de Medicina, Universidad del Salvador, Buenos Aires, Argentina.

    For their study, the team prospectively enrolled 31 consecutive premenopausal women, between 18-49 years of age, with newly diagnosed celiac disease, and 22 healthy women of similar age and body mass index.

    Compared with controls the peripheral bones of celiac disease patients showed significantly lower total density mg/cm(3). Celiac patients also showed significantly lower cortical densit in both regions.

    Although celiac patients also showed lower cortical thickness, there was no significant inter-group difference (a-8% decay with p 0.11 in both bones). The 22 patients with symptomatic celiac disease showed a greater bone micro-architectural deficit than those with subclinical, or "silent" celiac disease.

    The team used HR-pQCT identify significant deterioration in the micro-architecture of trabecular and cortical compartments of peripheral bones. Overall, impairment was marked by lower trabecular number and thickness, which increased trabecular network heterogeneity, and lower cortical density and thickness.

    The team notes that they expect a follow-up on this group of patients to reveal whether a gluten-free diet promotes bone healing, and if so, to what extent.

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    I was diagnosed at age 33 and have been on a very strict gluten-free diet since then (24 years). Of note, my studies did not show a significant loss of bone or any type of osteopenia then or after menopause. At the time of diagnosis, the GI doc said I did not have celiac disease through the entire small intestine; rather, just high up in my duodenum. Don't know if that makes a difference.

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    I was diagnosed with osteoporosis at age 45 (pre-menopausal) and my gynecologist referred me to an endocrinologist to determine what was causing it. Blood work and then endoscopy confirmed celiac. I've been gluten-free for 13 years now. My bone density has only begun to improve since I've started weight lifting 2 years ago. gluten-free diet and vitamin D + calcium supplements had not helped prior to exercise regimen.

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    Once I moved to a gluten-free diet, I increased weight without increasing size - which could only have been due to increased bone weight. Prior to that, I was always under-weight in spite of eating heartily.

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    Prior to my celiac diagnosis, among the plethora of health issues (most of which were attributed to short and long term complications of radiation and chemotherapy I had while battling cancer at the age of 19) I had and prescriptions I was on for every symptom I had from a different specialist, I also had a bone scan that showed I had osteoporosis and the GYN wanted to put me on another prescription for that too. Luckily, before I went on my 16th prescription medication, a C-difficile infection followed by an endoscope and biopsy FINALLY told the real story.

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    When I was diagnosed 10 years ago, I had full blown osteoporosis. I held myself to a very strict gluten-free diet. 5 years after diagnosis, and Mai raining that diet, my osteoporosis was completely reversed.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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