title: Pathologic bone alterations in celiac disease: etiology, epidemiology, and treatment.
abstract: Low bone mineral density (BMD), osteopenia, and osteoporosis are frequent complications of celiac disease (CD). The etiology of pathologic bone alterations in CD is multifactorial; however, two main mechanisms are involved: intestinal malabsorption and chronic inflammation. A strict gluten-free diet (GFD) is thought to be the only effective treatment for CD; but treating bone complications related to CD remains complex. The objective of this review is to elucidate the bones problems related to CD and to increase awareness of osteoporosis development, considered as a sign of atypical CD presentation. Currently, a question of whether GFD alone is an effective treatment to correct the bone alterations in patients with CD is under debate. This review presents factors contributing to pathologic bone derangement, recent research on the epidemiology of low BMD, osteoporosis, and fractures, and the treatment of bone problems in patients with CD. The roles of calcium and transport mechanisms are additionally presented.
authors.affiliation: Institute of Animal Reproduction and Food Research of the Polish Academy of Sciences, Department of Chemistry and Biodynamics of Food, Olsztyn, Poland. Electronic address: u.krupa-kozak@pan.olsztyn.pl.
authors.forename: Urszula
authors.initials: U
authors.lastname: Krupa-Kozak
mesh_terms: D015519:Bone Density; D001842:Bone and Bones / Q000473:pathology*; D002136:Calcium, Dietary / Q000008:administration & dosage; D002446:Celiac Disease / Q000150:complications / Q000453:epidemiology* / Q000473:pathology / Q000628:therapy; D055050:Diet, Gluten-Free; D019587:Dietary Supplements; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000628:therapy; D006801:Humans; D010024:Osteoporosis / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology* / Q000628:therapy*; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: D002136:Calcium, Dietary; D014807:Vitamin D
keywords: Bone density; Calcium; Celiac disease; Gluten; Inflammation; Intestinal absorption; Osteoporosis