title: Risk of low bone mineral density and low body mass index in patients with non-celiac wheat-sensitivity: a prospective observation study.
abstract: BACKGROUND
  Non-celiac gluten sensitivity (NCGS) or 'wheat sensitivity' (NCWS) is included in the spectrum of gluten-related disorders. No data are available on the prevalence of low bone mass density (BMD) in NCWS. Our study aims to evaluate the prevalence of low BMD in NCWS patients and search for correlations with other clinical characteristics.
  
  
  METHODS
  This prospective observation study included 75 NCWS patients (63 women; median age 36 years) with irritable bowel syndrome (IBS)-like symptoms, 65 IBS and 50 celiac controls. Patients were recruited at two Internal Medicine Departments. Elimination diet and double-blind placebo controlled (DBPC) wheat challenge proved the NCWS diagnosis. All subjects underwent BMD assessment by Dual Energy X-Ray Absorptiometry (DXA), duodenal histology, HLA DQ typing, body mass index (BMI) evaluation and assessment for daily calcium intake.
  
  
  RESULTS
  DBPC cow's milk proteins challenge showed that 30 of the 75 NCWS patients suffered from multiple food sensitivity. Osteopenia and osteoporosis frequency increased from IBS to NCWS and to celiac disease (CD) (P <0.0001). Thirty-five NCWS patients (46.6%) showed osteopenia or osteoporosis. Low BMD was related to low BMI and multiple food sensitivity. Values of daily dietary calcium intake in NCWS patients were significantly lower than in IBS controls.
  
  
  CONCLUSIONS
  An elevated frequency of bone mass loss in NCWS patients was found; this was related to low BMI and was more frequent in patients with NCWS associated with other food sensitivity. A low daily intake of dietary calcium was observed in patients with NCWS.
authors.forename: Antonio
authors.initials: A
authors.lastname: Carroccio
authors.forename: Maurizio
authors.initials: M
authors.lastname: Soresi
authors.forename: Alberto
authors.initials: A
authors.lastname: D'Alcamo
authors.forename: Carmelo
authors.initials: C
authors.lastname: Sciumè
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Iacono
authors.forename: Girolamo
authors.initials: G
authors.lastname: Geraci
authors.forename: Ignazio
authors.initials: I
authors.lastname: Brusca
authors.forename: Aurelio
authors.initials: A
authors.lastname: Seidita
authors.forename: Floriana
authors.initials: F
authors.lastname: Adragna
authors.forename: Miriam
authors.initials: M
authors.lastname: Carta
authors.forename: Pasquale
authors.initials: P
authors.lastname: Mansueto
mesh_terms: D000328:Adult; D015992:Body Mass Index; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000150:complications / Q000453:epidemiology; D002446:Celiac Disease / Q000150:complications; D004311:Double-Blind Method; D005260:Female; D005983:Glutens / Q000009:adverse effects*; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications*; D043183:Irritable Bowel Syndrome / Q000150:complications; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012306:Risk; D055815:Young Adult
chemical_list: D005983:Glutens