Bone recovery after a gluten-free diet: a 5-year follow-up study.
The purpose of our study was to investigate the recovery of bone disease in celiac patients during 5 years of a gluten-free diet. The study group consisted of 28 newly diagnosed celiac patients (9 men, 19 women) recruited between 1990 and 1991. Six patients withdrew from the 5-year follow-up. Compliance with the gluten-free diet was good: 96% at 1 year and 82% at 5 years. During the follow-up period, the body mass index increased significantly (8%). Both in men and women, bone mineral density (BMD) values determined by dual X-ray absorptiometry (DXA) increased at the lumbar spine (2%), the femoral neck (1%), the trochanter (6%), and the Wards' area (3%) during the follow-up. The increase in BMD was found already during the first year of follow-up. After 1 year, BMD increased or remained the same in 69% of the patients at the lumbar spine and in 67% of the patients at the femoral neck, 89% of patients at the throchanter, and 67% of patients at the Wards' area. During the 5-year follow-up, these figures were 52%, 46%, 68%, and 59%, respectively. At the baseline, 19 out of 28 patients, after 1 year, 14 out of 26 patients, and after 5 years, 2 out of 26 patients had low serum 25(OH)D vitamin values (p = 0.0001). A high serum parathormone value was noticed in 6 out of 25 patients at the baseline, but after 1 year, 5 of them showed normalized values (p = 0.03). According to our results, bone disease in celiac patients is cured in most patients during 5 years on a gluten-free diet. The improvement in BMD mostly occurred already within the first year after the establishment of a gluten-free diet.
Kemppainen
T
T
Department of Clinical Nutrition, University of Kuopio, Finland. Tarja.Kemppainen@uku.fi
Kröger
H
H
Janatuinen
E
E
Arnala
I
I
Lamberg-Allardt
C
C
Kärkkäinen
M
M
Kosma
V M
VM
Julkunen
R
R
Jurvelin
J
J
Alhava
E
E
Uusitupa
M
M
D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D015519:Bone Density / Q000502:physiology*; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000502:physiology*; D002446:Celiac Disease / Q000097:blood / Q000178:diet therapy* / Q000503:physiopathology; D018753:Diet, Protein-Restricted; D005260:Female; D005500:Follow-Up Studies; D005983:Glutens; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000178:diet therapy* / Q000503:physiopathology; D010281:Parathyroid Hormone / Q000097:blood; D017698:Postmenopause; D017697:Premenopause; D011446:Prospective Studies; D014807:Vitamin D / Q000097:blood
D015415:Biomarkers; D010281:Parathyroid Hormone; D014807:Vitamin D; D005983:Glutens