Long-term effect of gluten restriction on bone mineral density of patients with coeliac disease
Article first published online: 7 JUL 2008
Blackwell Science Ltd, Oxford
Alimentary Pharmacology & Therapeutics
Volume 11, Issue 1, pages 157–164, February 1997
How to Cite
BAI, J. C., GONZALEZ, D., MAUTALEN, C., MAZURE, R., PEDREIRA, S., VAZQUEZ, H., SMECUOL, E., SICCARDI, A., CATALDI, M., NIVELONI, S., BOERR, L. A. and MAURIÑO, E. (1997), Long-term effect of gluten restriction on bone mineral density of patients with coeliac disease. Alimentary Pharmacology & Therapeutics, 11: 157–164. doi: 10.1046/j.1365-2036.1997.112283000.x
- Issue published online: 7 JUL 2008
- Article first published online: 7 JUL 2008
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Aim: To assess the long-term effect of a gluten-free diet on bone mineral density of adults with untreated coeliac disease.
Methods: Bone mineral density was assessed at baseline and after a mean duration of 37 months of treatment in 25 unselected newly diagnosed coeliac patients.
Results: At baseline, osteopenia (>−1 s.d. below normal) was evident in the lumbar spine and total skeleton in 18 (72%) and 21 (84%) patients, respectively. At the end of the study, bone density had increased (mean bone mass Z-score increase: Z-score +1.0 for the lumbar spine and +1.1 for total skeleton) in 22 and 23 patients, respectively. Patients who adhered to strict gluten restriction (n=15) demonstrated a similar bone remineralization in the spine than those patients with partial compliance (n=10) (mean Z-score increase: +1.0, in both areas). A greater mean annual change in Z-score in the total skeleton was noted in patients who followed strict gluten restriction (0.4±0.1) respect to those with partial compliance (0.3±0.1); however, this difference was not statistically significant. Pre-menopausal women had significantly greater remineralization that post-menopausals (P>0.05). Remineralization showed an inverse correlation with the degree of basal osteopenia (r=−0.525; P<0.002).
Conclusions: Long-term treatment with gluten-free diet produces a significant improvement in bone density in coeliac patients. Remineralization was more pronounced in patients who better comply with gluten-free diet, in pre-menopausal women and in patients with the lowest baseline bone mineral density.