title: Bone and Celiac Disease.
abstract: More than 50% of untreated patients with celiac disease (CD) have bone loss detected by bone densitometry (dual-energy X-ray absorptiometry:DXA). Moreover, patients with CD are more likely to have osteoporosis and fragility fractures, especially of the distal radius. Although still controversial, we recommend DXA screening in all celiac disease patients, particularly in those with symptomatic CD at diagnosis and in those who present risk factors for fracture such as older age, menopausal status, previous fracture history, and familial hip fracture history. Bone microarchitecture, especially the trabecular network, may be deteriorated, explaining the higher fracture risk in these patients. Adequate calcium and vitamin D supplementation are also recommended to optimize bone recovery, especially during the first years of gluten free diet (GFD). If higher fracture risk persists after 1 or 2 years of GFD, specific osteoactive treatment may be necessary to improve bone health.
authors.affiliation: IDIM, Instituto de Diagnóstico e Investigaciones Metabólicas, Libertad 836, (1012), Buenos Aires, Argentina. mbzanchetta@idim.com.ar.|Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina. mbzanchetta@idim.com.ar.
authors.forename: María Belén
authors.initials: MB
authors.lastname: Zanchetta
authors.affiliation: IDIM, Instituto de Diagnóstico e Investigaciones Metabólicas, Libertad 836, (1012), Buenos Aires, Argentina.|Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina.
authors.forename: Vanesa
authors.initials: V
authors.lastname: Longobardi
authors.affiliation: Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología ¨Dr. C. Bonorino Udaondo¨ and Cátedra de Gastroenterología Facultad de Medicina, Universidad del Salvador, Buenos Aires, Argentina.
authors.forename: Julio César
authors.initials: JC
authors.lastname: Bai
mesh_terms: D015519:Bone Density; D001847:Bone Diseases / Q000209:etiology / Q000473:pathology; D001842:Bone and Bones / Q000473:pathology; D002446:Celiac Disease / Q000150:complications* / Q000178:diet therapy; D055050:Diet, Gluten-Free; D050723:Fractures, Bone / Q000453:epidemiology* / Q000209:etiology; D006801:Humans
keywords: Bone disorders; Bone microarchitecture; Celiac disease; Fractures; Gluten-free diet; HRp-QCT; Osteoporosis