CELIAC-DISEASE AND BONE-MINERAL DENSITY IN ADULT FEMALE-PATIENTS

A cross sectional study was undertaken to examine the relationship bet ween coeliac disease and bone mineral density. The 135 female coeliac patients registered on the database of the Department of Gastroenterol ogy at Hull Royal Infirmary were approached by letter, advising them o f a potential risk of osteoporosis and inviting them to undergo bone d ensitometry. A total of 81 registered women (60%) attended the Osteopo rosis Laboratory, Princess Royal Hospital and underwent dual energy x ray absorptiometry at the lumbar spine (L2-L4) and femoral neck. Histo rical data relating to the time of diagnosis and adherence to a gluten free diet were obtained. A control group was selected from the local normal population and was first matched for height, weight, and menopa usal status. Postmenopausal patients were then further matched to cont rols of equivalent menopausal age. In coeliac patients, bone mineral d ensity expressed in g/cm(2) as mean (SD) was significantly lower at th e lumbar spine (1.076 (0.186)) than in the control group (1.155 (0.143 ), p < 0.001). This was also the case at the femoral neck (0.887 (0.14 2) versus 0.965 (0.127), p < 0.001). When the coeliac patients were st ratified by menopausal status, it was found that femoral neck bone min eral density was significantly below control values in both premenopau sal and postmenopausal women. Spinal bone mineral density exhibited a significant decrement only in the postmenopausal group. The age at dia gnosis of coeliac disease and adherence to a gluten free diet did not influence bone mineral density at either hip or spine. These results c onfirm coeliac patients' higher risk of osteopenia. Coeliac disease sh ould be added to the List of medical conditions which constitute an in dication for bone densitometry in order that the individual risk of os teoporosis related fracture may be determined.