Osteoporosis in a North American adult population with celiac disease

OBJECTIVE: Osteoporosis, common in European and South American adults with celiac disease, has not been reported in those patients with celiac disease residing in North America. We therefore evaluated bone density in a group of patients from the United States. METHODS: Patients (105 women and 23 men) with celiac disease, who had compl eted a questionnaire and had bone mineral density (BMD) measured by dual en ergy x-ray absorptiometry, were evaluated. The patients were an aver age ag e of 56 yr old (range 21-83 yr) and had been on a gluten-free diet from 0 m onths to 46 yr (mean 7.5 yr). RESULTS: Osteoporosis (T score <-2.5) was present in 34% of the patients at the lumbar spine, 27% at the femoral neck, and 36% at the radius. Low bone mass (T score between -1.0 and -2.5) was present in 38% at the lumbar spin e, 44% at the femoral neck, and 32% at the radius. When compared to age-mat ched controls, men were more severely affected than women. BMD did not diff er between those on a gluten-free diet and those who had not begun therapy. BMD was remeasured 16 +/- 2 months after beginning a gluten-free diet in 5 patients; it increased by 7.5% at the femoral neck (p < 0.02). In 16 patie nts who had followed a gluten-free diet for an average of 12 yr, BMD remain ed stable over an additional 2 yr of observation. CONCLUSIONS: Osteoporosis and low bone mass often affect North American adu lts with celiac disease, whether or not they are on dietary therapy. Routin e screening for osteoporosis is indicated in patients with celiac disease. (Am J Gastroenterol 2001;96:112-119. (C) 2001 by Am. Coll. of Gastroenterol ogy).