Coeliac disease and bone mineral density in adult female patients.

Abstract

(Gut 1995; 37: 639-642)

Long-term Fracture Risk in Patients with Celiac Disease: A Population-Based Study in Olmsted County, Minnesota

“…It is also possible that the persistent risk of fractures is due to other factors such as muscle weakness or neurologic disturbance, though that would not necessarily explain the trend for increased frequencies of spontaneous and axial fractures in the celiac cases. Based on studies involving other skeletal disorders, axial sites would be expected to show greater response to gluten-free diet, with previous studies showing a greater increase in axial BMD than appendicular BMD [50][51][52][53][54].…”

Fracture experience of patients with coeliac disease: a population based survey

“…26 Nevertheless, findings such a small increased risk require explanation as patients with coeliac disease undoubtedly have an increased risk of osteoporosis. [2][3][4][5][6][7] The reasons for this apparent paradox are probably due to the complex interplay of other risk factors for fracture and bone mineral density. 27 28 For example, risk of falling, selective use of HRT and/or other drugs that influence fracture risk are likely to be contributory factors.…”

“…In these studies between 40% and 70% of adult coeliacs had bone mineral density measurements more than one standard deviation below the population mean (with >16% being expected). [2][3][4][5][6] Others have reported that up to half of adult coeliacs have osteoporosis. 7 As the risk of sustaining an osteoporotic fracture is estimated to double with each standard deviation decrease in bone mineral density, various groups, including the British Society of Gastroenterology, have recommended that adult coeliacs should have regular bone scans and if osteoporosis is detected prolonged treatment with hormone replacement therapy or bisphosphonates.…”

Complications of coeliac disease: are all patients at risk?

“…[56][57][58][59][60][61][62][63][64][65][66] The World Health Organization defines osteopenia as a T score (number of standard deviations of patient's bone density below that of the young adult mean) of between 21 and 22.5, and osteoporosis as a T score of ,22.5 on BMD scanning. Most studies confirm that approximately one third of adults are osteopenic, one third are osteoporotic and only one third have normal bone density at diagnosis of coeliac disease.…”