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Celiac Disease and Risk of Associated Bone Fractures 04/10/2007 - According to a recent Swedish research report, the adverse immune response to gluten may be tied to a specific set of dendrite cells in the small intestine. A team led by Dr. J.F. Ludvigsson of Orebro University Hospital set out to compare rates of bone fracture in patients with celiac disease versus those from normal individuals. The goal of the study was to assess the connection between celiac disease and fractures.

The study used Cox regression to examine over 13,000 patients with celiac disease, along with 65,000 people among the general population who were sex and age-matched. The Study tallied 1365 first hip fractures 4867 non-hip fractures.

The results showed celiac disease to be a contributing factor in fractures at a rate of 4 fractures per 100,000 people per year, compared to a rate of 2 fractures per 100,000 people per year for non-celiacs.

The study calculated the following hazard ratios for celiac-associated hip fracture:

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  • Adults: ¼ 2.1; 95% CI ¼ 1.8–2.4
  • Children: ¼ 2.6; 95% CI ¼ 1.1–6.2

For celiac-associated non-hip fractures, the hazard ratios were:

  • Adults: ¼ 1.4; 95% CI ¼ 1.3–1.5
  • Children: ¼ 1.1; 95% CI ¼ 1.0–1.2

The study concludes that both adults and children with celiac disease run a significant risk of increased hip fractures and fractures of any type. These increased risks continue for at least 20 years following diagnosis. The study did not measure risk for undiagnosed celiacs, but common sense would indicate that the risks would be the same, or perhaps even greater. Clearly, more research is needed to determine the reasons for these increased fracture risks among celiac patients, and also to determine the associated risks for non-celiacs.

Aliment Pharmacol Ther 25, 273–285

health writer who lives in San Francisco and is a frequent author of articles for welcomes your comments below (registration is NOT required).

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2 Responses:

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said this on
15 Nov 2007 3:30:02 PM PDT
Thank you for the article on this important health risk. At the age of 53- after living gluten-free for six years and taking calcium-magnesium supplements for more than fifteen years- I fell in my kitchen and broke my left hip.

I am now in the long slow process of recovery, not knowing whether the three screws inserted into my hip will allow me to save my ball joint (when the ball is fractured from the femoral neck, blood supply is broken). In six months- we shall see. I may face more surgery and a total hip replacement.

What might I have done differently to help prevent this? That is my question. Unfortunately, the doctors I have known have offered me no true wisdom.


Karina aka Gluten-Free Goddess

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said this on
31 Aug 2009 7:45:06 PM PDT
I too thank you for posting this article! Just a few weeks ago I learned that I have celiac disease. Unfortunately, although I'm only 25 years old, I've had 22 metatarsal stress fractures (unknown cause, but occurring post reconstructive surgeries to both legs to correct birth defects), stress fractures in my forearms and hands (unknown cause, but I use crutches & wheelchair frequently due to previous & chronic pain), 2 fractured ribs (car accident), and stress fractures in my lower back (car accident). I feel like I'm made of glass. I too take supplements and make conscious efforts to have a diet rich in calcium. I'm encouraged that researchers and doctors are beginning to take a look at the relationship between celiac disease and bone fractures.

Best wishes for a full recovery, Katrina! Thank you for your blog as well! I'm in the throes of trying to figure out all this gluten-free stuff for the first time (it's overwhelming!), and I've found your blog as well as to be very beneficial.

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