title: Impaired Bone Microarchitecture Improves After One Year On Gluten-Free Diet: A Prospective Longitudinal HRpQCT Study in Women With Celiac Disease.
abstract: We have recently identified a significant deterioration of bone microarchitecture in premenopausal women with newly diagnosed celiac disease (CD) using high-resolution peripheral quantitative computed tomography (HRpQCT). The aim of this work was to assess changes in bone microarchitecture after 1 year on a gluten-free diet (GFD) in a cohort of premenopausal women. We prospectively enrolled 31 consecutive females at diagnosis of CD; 26 of them were reassessed 1 year after GFD. They all underwent HRpQCT scans of distal radius and tibia, areal BMD by DXA, and biochemical tests (bone-specific parameters and CD serology) at both time points. Secondary, we compared 1-year results with those of a control group of healthy premenopausal women of similar age and BMI in order to assess whether the microarchitectural parameters of treated CD patients had reached the values expected for their age. Compared with baseline, the trabecular compartment in the distal radius and tibia improved significantly (trabecular density, trabecular/bone volume fraction [BV/TV] [p < 0.0001], and trabecular thickness [p = 0.0004]). Trabecular number remained stable in both regions. Cortical density increased only in the tibia (p = 0.0004). Cortical thickness decreased significantly in both sites (radius: p = 0.03; tibia: p = 0.05). DXA increased in all regions (lumbar spine [LS], p = 0.01; femoral neck [FN], p = 0.009; ultradistal [UD] radius, p = 0.001). Most parameters continued to be significantly lower than those of healthy controls. This prospective HRpQCT study showed that most trabecular parameters altered at CD diagnosis improved significantly by specific treatment (GFD) and calcium and vitamin D supplementation. However, there were still significant differences with a control group of women of similar age and BMI. In the prospective follow-up of this group of patients we expect to be able to assess whether bone microarchitecture attains levels expected for their age. © 2016 American Society for Bone and Mineral Research.
authors.affiliation: Instituto de Diagnóstico e Investigaciones Metabólicas (IDIM), Buenos Aires, Argentina.|Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina.
authors.forename: María Belén
authors.initials: MB
authors.lastname: Zanchetta
authors.affiliation: Instituto de Diagnóstico e Investigaciones Metabólicas (IDIM), 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,", Buenos Aires, Argentina.
authors.forename: Florencia
authors.initials: F
authors.lastname: Costa
authors.affiliation: Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.
authors.forename: Gabriela
authors.initials: G
authors.lastname: Longarini
authors.affiliation: Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.
authors.forename: Roberto Martín
authors.initials: RM
authors.lastname: Mazure
authors.affiliation: Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.
authors.forename: María Laura
authors.initials: ML
authors.lastname: Moreno
authors.affiliation: Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.
authors.forename: Horacio
authors.initials: H
authors.lastname: Vázquez
authors.affiliation: Instituto de Diagnóstico e Investigaciones Metabólicas (IDIM), Buenos Aires, Argentina.
authors.forename: Fernando
authors.initials: F
authors.lastname: Silveira
authors.affiliation: Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.
authors.forename: Sonia
authors.initials: S
authors.lastname: Niveloni
authors.affiliation: Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.
authors.forename: Edgardo
authors.initials: E
authors.lastname: Smecuol
authors.affiliation: Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.
authors.forename: María
authors.initials: M
authors.lastname: de la Paz Temprano
authors.affiliation: Instituto de Diagnóstico e Investigaciones Metabólicas (IDIM), Buenos Aires, Argentina.|Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina.
authors.forename: Fabio
authors.initials: F
authors.lastname: Massari
authors.affiliation: Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.
authors.forename: Emilia
authors.initials: E
authors.lastname: Sugai
authors.affiliation: Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.
authors.forename: Andrea
authors.initials: A
authors.lastname: González
authors.affiliation: Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.
authors.forename: Eduardo César
authors.initials: EC
authors.lastname: Mauriño
authors.affiliation: Instituto de Diagnóstico e Investigaciones Metabólicas (IDIM), Buenos Aires, Argentina.|Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina.
authors.forename: Cesar
authors.initials: C
authors.lastname: Bogado
authors.affiliation: Instituto de Diagnóstico e Investigaciones Metabólicas (IDIM), Buenos Aires, Argentina.|Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina.
authors.forename: José R
authors.initials: JR
authors.lastname: Zanchetta
authors.affiliation: Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.|Cátedra de Gastroenterología Facultad de Medicina, Universidad del Salvador, Buenos Aires, Argentina.
authors.forename: Julio César
authors.initials: JC
authors.lastname: Bai
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D015519:Bone Density; D001842:Bone and Bones / Q000000981:diagnostic imaging / Q000473:pathology*; D002118:Calcium / Q000378:metabolism; D016022:Case-Control Studies; D002446:Celiac Disease / Q000178:diet therapy* / Q000473:pathology*; D003710:Demography; D055050:Diet, Gluten-Free; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D010349:Patient Compliance; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D014807:Vitamin D / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D014807:Vitamin D; D002118:Calcium
keywords:  BONE MICROARCHITECTURE; BONE DISORDERS; CELIAC DISEASE; FRACTURES; GLUTEN-FREE DIET; HRpQCT; OSTEOPOROSIS