Bone mineral density at diagnosis of celiac disease and after 1 year of gluten-free diet.
Atypical or silent celiac disease may go undiagnosed for many years and can frequently lead to loss of bone mineral density, with evolution to osteopenia or osteoporosis. The prevalence of the latter conditions, in case of new diagnosis of celiac disease, has been evaluated in many studies but, due to the variability of epidemiologic data and patient features, the results are contradictory. The aim of this study was to evaluate bone mineral density by dual-energy X-ray absorptiometry in 175 consecutive celiac patients at time of diagnosis (169 per-protocol, 23 males, 146 females; average age 38.9 years). Dual-energy X-ray absorptiometry was repeated after 1 year of gluten-free diet in those with T-score value <-1 at diagnosis. Stratification of patients according to sex and age showed a higher prevalence of low bone mineral density in men older than 30 years and in women of all ages. A 1-year gluten-free diet led to a significant improvement in lumbar spine and femoral neck mean T-score value. We propose that dual-energy X-ray absorptiometry should be performed at diagnosis of celiac disease in all women and in male aged >30 years, taking into account each risk factor in single patients.
Department of Gastroenterology, Molinette Hospital, University of Turin, 10126 Turin, Italy.
Stefano
S
Pantaleoni
Department of Gastroenterology, Molinette Hospital, University of Turin, 10126 Turin, Italy.
Massimo
M
Luchino
Department of Gastroenterology, Molinette Hospital, University of Turin, 10126 Turin, Italy.
Alessandro
A
Adriani
Department of Gastroenterology, Molinette Hospital, University of Turin, 10126 Turin, Italy ; Clinic of Gastroenterology and Hepatology, Via Cavour 31, 10123 Turin, Italy.
Rinaldo
R
Pellicano
Department of Gastroenterology, Molinette Hospital, University of Turin, 10126 Turin, Italy.
Davide
D
Stradella
Department of Gastroenterology, Molinette Hospital, University of Turin, 10126 Turin, Italy.
Davide Giuseppe
DG
Ribaldone
Department of Gastroenterology, Molinette Hospital, University of Turin, 10126 Turin, Italy.
Nicoletta
N
Sapone
Gerontology and Bone Metabolic Disease Section, Molinette Hospital, University of Turin, 10126 Turin, Italy.
Gian Carlo
GC
Isaia
Gerontology and Bone Metabolic Disease Section, Molinette Hospital, University of Turin, 10126 Turin, Italy.
Marco
M
Di Stefano
Department of Gastroenterology, Molinette Hospital, University of Turin, 10126 Turin, Italy.
Marco
M
Astegiano
D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D002446:Celiac Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000178:diet therapy* / Q000473:pathology; D055050:Diet, Gluten-Free; D005260:Female; D005272:Femur Neck / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D012307:Risk Factors