Normal Bone Mineral Density Associates with Duodenal Mucosa Healing in Adult Patients with Celiac Disease on a Gluten-Free Diet.
Impairment of bone mineral density (BMD) is frequent in celiac disease (CD) patients on a gluten-free diet (GFD). The normalization of intestinal mucosa is still difficult to predict. We aim to investigate the relationship between BMD and duodenal mucosa healing (DMH) in CD patients on a GFD. Sixty-four consecutive CD patients on a GFD were recruited. After a median period of a 6-year GFD (range 2-33 years), patients underwent repeat duodenal biopsy and dual-energy X-ray absorptiometry (DXA) scan. Twenty-four patients (38%) displayed normal and 40 (62%) low BMD, 47 (73%) DMH, and 17 (27%) duodenal mucosa lesions. All patients but one with normal BMD (23 of 24, 96%) showed DMH, while, among those with low BMD, 24 (60%) did and 16 (40%) did not. At multivariate analysis, being older (odds ratio (OR) 1.1, 95% confidence interval (CI) 1.03-1.18) and having diagnosis at an older age (OR 1.09, 95% CI 1.03-1.16) were associated with low BMD; in turn, having normal BMD was the only variable independently associated with DMH (OR 17.5, 95% CI 1.6-192). In older CD patients and with late onset disease, BMD recovery is not guaranteed, despite a GFD. A normal DXA scan identified CD patients with DMH; thus, it is a potential tool in planning endoscopic resampling.
Department of Health Sciences, University of Catanzaro "Magna Graecia", Viale Europa, Germaneto, Catanzaro 88100, Italy. tiziana.larussa@gmail.com.
Tiziana
T
Larussa
Department of Health Sciences, University of Catanzaro "Magna Graecia", Viale Europa, Germaneto, Catanzaro 88100, Italy. e.suraci@libero.it.
Evelina
E
Suraci
Department of Health Sciences, University of Catanzaro "Magna Graecia", Viale Europa, Germaneto, Catanzaro 88100, Italy. graziaimeneo@hotmail.it.
Maria
M
Imeneo
Department of Health Sciences, University of Catanzaro "Magna Graecia", Viale Europa, Germaneto, Catanzaro 88100, Italy. raffaellamarasco1@gmail.com.
Raffaella
R
Marasco
Department of Health Sciences, University of Catanzaro "Magna Graecia", Viale Europa, Germaneto, Catanzaro 88100, Italy. luzza@unicz.it.
Francesco
F
Luzza
D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D015519:Bone Density; D002446:Celiac Disease / Q000178:diet therapy* / Q000473:pathology* / Q000503:physiopathology; D055050:Diet, Gluten-Free; D004386:Duodenum / Q000473:pathology*; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology*; D008297:Male; D008875:Middle Aged
bone disorders; celiac disease; histopathology; intestinal mucosa healing; osteoporosis