Influence of pattern of clinical presentation and of gluten-free diet on bone mass and metabolism in adult coeliac disease

G. R. Corazza, A. Di Sario, L. Cecchetti, R. A. Jorizzo, M. Di Stefano, L. Minguzzi, G. Brusco, M. Bernardi, G. Gasbarrini

Research output: Contribution to journalArticlepeer-review

Abstract

Since no information is available on bone derangements in subclinical coeliac disease (CD), we evaluated bone mineral density (BMD, expressed as z score) at lumbar spine, by X-ray dual-photon absorptiometry, and serum indices of bone metabolism and remodeling in 14 subclinical or silent patients, 10 classical patients, and 15 healthy volunteers all on a gluten-containing diet. In the subclinical group, BMD at lumbar spine was significantly higher than in the classical group (-1.3 ± 0.8, 73% vs. -2.6 ± 0.6, 88%, respectively; p <0.001), but significantly lower than in volunteers (+0.4 ± 1.1, 104%; p <0.001). Similar changes were observed in serum calcium, whereas, as regards parathyroid hormone, no significant difference was found between subclinical and classical patients. 25-vitamin D was significantly lower, and 1,25-vitamin D was significantly higher in subclinical and classical patients than in healthy volunteers. Indices of bone remodeling were higher in the subclinical and classical groups than in the volunteers, but lower in the subclinical than in classical patients. Eight subclinical and 8 classical patients were re-examined after a period of gluten-free diet (GFD), and in both groups BMD had significantly improved. Our results show that osteopenia is a frequent feature also in subclinical CD, although the extent of bone and mineral metabolism derangements is lower than in classical CD. GFD is able to normalize BMD in subclinical and to significantly improve it in classical patients.

Original languageEnglish
Pages (from-to)525-530
Number of pages6
JournalBone
Volume18
Issue number6
DOIs
Publication statusPublished - Jun 1996

Keywords

  • Bone
  • Bone metabolism
  • Coeliac disease
  • Dual energy X-ray absorptiometry
  • Gluten-free diet
  • Subclinical coeliac disease

ASJC Scopus subject areas

  • Physiology
  • Hematology

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