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

Thomason, K.; West, Joe; Logan, Richard F.; Coupland, Carol; Holmes, Geoffrey

doi:10.1136/gut.52.4.518

Cited by 115 publications

(73 citation statements)

References 27 publications

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“…Strict adherence to a gluten-free diet (GFD) reverses these abnormalities and results in rapid gains in bone mass, especially in children [125]. Data from population-based studies suggest that the risk of fracture in patients with celiac disease may be modestly elevated compared to the general population [78,126,127], but prospective studies in patients compliant with a GFD have not yet been performed. In addition, the prevalence of celiac disease in adult patients referred for idiopathic osteoporosis appears to be similar than that of the general population [112,[128][129][130][131].…”

Section: Celiac Diseasementioning

confidence: 97%

Chronic pediatric inflammatory diseases: Effects on bone

Viswanathan

Sylvester

2007

Rev Endocr Metab Disord

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In children, chronic inflammatory diseases present a significant challenge to long-term skeletal health. These conditions are often associated with poor appetite and suboptimal overall nutrition, altered nutrient utilization, delayed puberty, inactivity, and reduced muscle mass, all of which can alter bone metabolism. In addition, bone cell activity is susceptible to the effects of the immune response that characterizes these diseases. Moreover, drugs used to treat these maladies, notably glucocorticoids, may have negative effects on bone formation and on linear growth in developing children. As a result, predicted peak bone mass may not be achieved, and fracture risk may be increased in the short term or in the future. Studies using primarily dual energy X-ray absorptiometry have documented that deficits in bone mass are common in these diseases. However, there are wide variations in the prevalence of low bone mass, largely due to differences in the characteristics of each study population. Recent studies provide insight into the pathogenesis of decreased bone mass in these conditions. In this paper we will provide an overview of the effects of chronic inflammatory conditions on bone mass in children. We will also present relevant data from adult patients, when pediatric data are scant or not available.

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Section: Celiac Diseasementioning

confidence: 97%

Chronic pediatric inflammatory diseases: Effects on bone

Viswanathan

Sylvester

2007

Rev Endocr Metab Disord

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“…Another study using a matched cohort design reported no increase in fracture risk in celiac disease compared with controls. However, this was based on patient recall and there was a lower response rate among controls than cases [16]. A recent study from the UK used the general practitioner database to show a moderately increased risk of fracture in those who were prescribed gluten-free products [17].…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2007

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Celiac disease is associated with decreased bone density, but there are conflicting data regarding fracture risk. We determined the fracture incidence relative to matched controls in a population-based cohort with celiac disease before and after diagnosis. Olmsted County residents with celiac disease (n = 83) diagnosed between 1950 and 2002 were compared with 166 gender and age matched controls. Fracture histories were ascertained from each subject's medical records. Celiac disease is linked to an increased fracture risk before and after diagnosis. Before the index date, cases had a fracture rate twice that of controls (CI: 1.0-3.9, P = 0.045) and 2.5-fold greater after the index date (CI: 1.1-5.6, P = 0.026). Appendicular and axial fractures were 2.5 (CI: 0.9-6.5) and 3.2 times more likely (CI: 1.0-10.5) after the index date. These observations support a rationale for earlier detection of celiac disease, and active management of bone disease before bone effects have occurred, to reduce the persistent risk of fractures.

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“…Osteopenia is major in the forearm which is the most common fracture site [4]. Gluten free diet may partially correct osteopenia but normalization is rarely observed [5].…”

Section: Bone Complicationsmentioning

confidence: 99%