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Premenopausal Women with Active Celiac Disease Show Significant Bone Impairment

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.

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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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5 Responses:

 
Mary
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said this on
26 Oct 2015 2:50:49 PM PDT
I was diagnosed at age 33 and have been on a very strict GF 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.

 
Laura
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said this on
02 Nov 2015 7:26:10 PM PDT
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 GF for 13 years now. My bone density has only begun to improve since I've started weight lifting 2 years ago. GF diet and vitamin D + calcium supplements had not helped prior to exercise regimen.

 
Jenny
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said this on
03 Nov 2015 3:38:50 PM PDT
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.

 
Christine
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said this on
09 Nov 2015 1:34:52 PM PDT
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.

 
Joette
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said this on
10 Nov 2015 12:40:56 PM PDT
When I was diagnosed 10 years ago, I had full blown osteoporosis. I held myself to a very strict GF diet. 5 years after diagnosis, and Mai raining that diet, my osteoporosis was completely reversed.




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Wish I could give you a hug. Unfortunately I know how that feels with Neurologists, Internists, Endocrinologists, Rheumatologists, GIs..... I got so tired of crying my drive home after refusing yet another script for Prozac. I do hope your GI can give you some answers even if it is just to rule out other possible issues. Keep on the gluten and we are here for you.

It is too bad that so often a full panel isn't done. Glad your appointment got moved up and hopefully you will get a clearer answer from the GI. Do keep eating gluten until the celiac testing is done. Once the testing is done do give the diet a good strict try. Hang in there.

That makes sense...I cried with relief when I got my diagnosis just because there was finally an answer. Please know that you are not weak or crazy. Keep pushing for testing. It could still be celiac, it could be Crohns. Push your Dr's to figure this out. Best wishes.

Thank you all very much. I actually cried when I got the answer. I wanted an explanation that I could "fix." Now I'm back to thinking I'm just weak and possibly crazy. I know I'm not crazy, but you know.

From what I have read online there is about a 1-3% chance of getting a false positive for celiac disease from a blood test. Was it a blood test that you got done? It may be worth your while to get a biopsy or more testing just to confirm it. I know being gluten free is a pain but it is better than getting cancer or other auto immune disorders.