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Bone Fracture Risk Double for Celiac Disease Patients

Celiac.com 11/17/2014 - There is a large body of data that show that celiac disease is associated with metabolic bone disorders, such as low bone mineral density. However, it is unclear whether this translates into an association between celiac disease and such hard clinical outcomes as bone fractures.

Photo: Wikimedia Commons--Thomas BjorkinA research team set out to systematically review and pool the data to better understand the nature of the relationship between celiac disease and the prevalence and incidence of bone fractures.

The research team included Katriina Heikkilä, Jo Pearce, Markku Mäki, and Katri Kaukinen. They are variously affiliated with the Departments of Internal Medicine at Seinäjoki Central Hospital and Tampere University Hospital, Finland, the School of Medicine at the University of Tampere, Finland, the Tampere Centre for Child Health Research at University of Tampere and Tampere University Hospital, Finland, and with the Division of Nutritional Sciences, School of Biosciences at the University of Nottingham in the United Kingdom.

For their study, they conducted a systematic search of Pubmed, Scopus, Web of Science and Cochrane Library in January 2014 for studies of celiac disease and bone fractures. They included observational studies of any design which compared bone fracture outcomes in individuals with and without celiac disease. Two investigators then independently gathered results from eligible studies.

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A meta-analyses of case-control and cross-sectional studies showed that bone fractures were almost twice as common in individuals with a clinically diagnosed celiac disease as in those without celiac disease. A meta-analyses of prospective studies showed that celiac disease at baseline was associated with a 30% increase (95% CI: 1.14, 1.50) in the risk of any fracture and a 69% increase in the risk of hip fracture (95% CI: 1.10, 2.59).

Two studies of patients with high concentrations of celiac disease-specific autoantibodies, but no celiac disease diagnosis, produced contradictory findings. The results of this study suggest that people with clinically diagnosed celiac disease face a greatly increased risk of hip fractures, and of fractures in general.

Further research is needed to determine whether unrecognized celiac disease carries a similar risk of bone fractures.

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1 Response:

 
Jill
Rating: ratingfullratingfullratingfullratingemptyratingempty Unrated
said this on
24 Nov 2014 4:31:26 PM PDT
Does this continue to be the case if the patient is strictly adhering to the gluten-free diet? Does their risk lessen?




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@cyclinglady thanks for checking in Restricted diet didn't do much. Still had some VA last time they checked. Heath still otherwise fine, so RCD remains unlikely. My sxs kick in lockstep with life stress, so that kind of points to some general IBS stuff on top of celiac disease. Very doubtful I'm getting any gluten in, but fingers crossed my system is just a little hyper-vigilant, as I ponder on this thread.

I have always noticed that the table wine in Europe is pretty damn good! I am a wine lover and so is my husband but he does like his Green's beer.

The reason they set the limit at 20ppms is that through scientific study, they have proven that the vast majority of people with Celiac Disease do not have an autoimmune reaction to amounts below that......it is a safe limit for most. Also, just because that limit is set at 20ppms, does not mean that gluten-free products contain that amount of gluten. Testing for lower levels becomes more expensive with each increment down closer to 0-5ppms, which translates into higher priced products. Unless you eat a lot of processed gluten-free food, which can have a cumulative affect for some, most people do well with the 20ppm limit.

I'm in the Houston area so I'm assuming there are plenty of specialists around, though finding one that accepts my insurance might be hard. This might sound dumb, but do I search for a celiac specialist?? I'm so new to this and want to feel confident in what is/isn't wrong with my daughter. I'm with you on trusting the specialist to know the current research.

Hi VB Thats sounds like a good plan. Would it help to know that a frustrating experience in seeking diagnosis isn't unusual With your IGG result I'm sure a part of you is still wondering if they are right to exclude celiac. I know just how you feel as I too had a negative biopsy, but by then a gluten challenge had already established how severely it affected me. So I was convinced I would be found to be celiac and in a funny way disappointed not to get the 'official' stamp of approval. Testing isnt perfect, you've already learned of the incomplete celiac tests offered by some organisations and the biopsy itself can only see so much. If you react positively to the gluten free diet it may mean you're celiac but not yet showing damage in a place they've checked, or it may be that you're non celiac gluten sensitive, which is a label that for a different but perhaps related condition which has only recently been recognised and for which research is still very much underway. We may not be able to say which but the good news is all of your symptoms: were also mine and they all resolved with the gluten free diet. So don't despair, you may still have found your answer, it just may be a bit wordier than celiac! Keep a journal when you're on the diet, it may help you track down your own answers. Best of luck!