Author(s): Kotze LM, Skare T, Vinholi A, Jurkonis L, Nisihara R
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Abstract BACKGROUND: Osteoporosis (OP) is a metabolic bone illness that may complicate celiac disease (CD). It can lead to devastating consequences because of low bone mass and fragility fractures. PURPOSE: To study the OP prevalence in a group of Brazilian patients with CD and the value of a gluten free diet (GFD). METHODS: Retrospective study of celiac female patients from a single University Center followed with bone densitometries. Results from densitometry made at first visit were compared with a second study after a median time of 5 years. During this period, patients were submitted to a GFD according to orientations from special program training. Calcium and vitamin D were prescribed to those patients who did not reach the minimal daily requirement through diet. RESULTS: Forty-one celiac female patients, mean age 46.1 ± 14.8 years, were included. The prevalence of osteopenia at first visit was 56.1\% and that of osteoporosis 29.2\%. Osteoporosis was associated with longer disease duration (p = 0.01). The second densitometry was performed in a median time of 5 years (range 1 to 13 years) and disclosed 58.9\% osteopenia and 28.2\% osteoporosis. The GFD improved bone mass, mainly at (of) spine (comparison of T score with p = 0.03 and of bone mass in g/cm2 with p = 0.02), but it was not sufficient to reduce the number of osteopenic (p = 0.9) and osteoporotic patients (p = 0.4). During the follow up period 25\% of osteoporotic patients developed low impact fractures. CONCLUSION: Bone health is notably impaired at baseline in CD patients, especially in those with a diagnostic delay. A GFD modestly improved bone mass density with low impact fractures occurring in one third of patients during the follow up period.
This article was published in Rev Esp Enferm Dig
and referenced in Journal of Clinical & Cellular Immunology