title: Long-term effect of gluten restriction on bone mineral density of patients with coeliac disease.
abstract: OBJECTIVE
  To assess the long-term effect of a gluten-free diet on bone mineral density of adults with untreated coeliac disease.
  
  
  METHODS
  Bone mineral density was assessed at baseline and after a mean duration of 37 months of treatment in 25 unselected newly diagnosed coeliac patients.
  
  
  RESULTS
  At baseline, osteopenia (> -1 s.d. below normal) was evident in the lumbar spine and total skeleton in 18 (72%) and 21 (84%) patients, respectively. At the end of the study, bone density had increased (mean bone mass Z-score increase: Z-score +1.0 for the lumbar spine and +1.1 for total skeleton) in 22 and 23 patients, respectively. Patients who adhered to strict gluten restriction (n = 15) demonstrated a similar bone remineralization in the spine than those patients with partial compliance (n = 10) (mean Z-score increase: +1.0, in both areas). A greater mean annual change in Z-score in the total skeleton was noted in patients who followed strict gluten restriction (0.4 +/- 0.1) respect to those with partial compliance (0.3 +/- 0.1); however, this difference was not statistically significant. Pre-menopausal women had significantly greater remineralization that post-menopausals (P > 0.05). Remineralization showed an inverse correlation with the degree of basal osteopenia (r = -0.525; P < 0.002).
  
  
  CONCLUSIONS
  Long-term treatment with gluten-free diet produces a significant improvement in bone density in coeliac patients. Remineralization was more pronounced in patients who better comply with gluten-free diet, in pre-menopausal women and in patients with the lowest baseline bone mineral density.
authors.affiliation: Clinical Department, Gastroenterology Hospital, Salvador University, Argentina.
authors.forename: J C
authors.initials: JC
authors.lastname: Bai
authors.forename: D
authors.initials: D
authors.lastname: Gonzalez
authors.forename: C
authors.initials: C
authors.lastname: Mautalen
authors.forename: R
authors.initials: R
authors.lastname: Mazure
authors.forename: S
authors.initials: S
authors.lastname: Pedreira
authors.forename: H
authors.initials: H
authors.lastname: Vazquez
authors.forename: E
authors.initials: E
authors.lastname: Smecuol
authors.forename: A
authors.initials: A
authors.lastname: Siccardi
authors.forename: M
authors.initials: M
authors.lastname: Cataldi
authors.forename: S
authors.initials: S
authors.lastname: Niveloni
authors.forename: L A
authors.initials: LA
authors.lastname: Boerr
authors.forename: E
authors.initials: E
authors.lastname: Mauriño
mesh_terms: D000328:Adult; D000368:Aged; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000178:diet therapy* / Q000209:etiology; D002446:Celiac Disease / Q000150:complications / Q000178:diet therapy*; D005260:Female; D005983:Glutens / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D005983:Glutens