Osteoporosis Linked to Celiac Disease

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Osteoporosis Linked to Celiac Disease

Special diet reversed bone loss, study finds.

By Ed Edelson

HealthDay Reporter

TUESDAY, March 1 (HealthDay News) --

People with osteoporosis, the bone-weakening condition, may also have

celiac disease and should be screened for that illness, too, a new study

recommends.

A review of 266 people being treated for osteoporosis found that nine of

them had celiac disease, an intestinal disorder caused by intolerance to

gluten found in wheat, rye and other grains. Just one of 574 people

without the bone disease also suffered from celiac disease, the study

found.

" Our results suggest that as many as 3 to 4 percent of patients who have

osteoporosis have the bone condition as a consequence of having celiac

disease, " said Dr. F. Stenson, a professor of medicine at

Washington University School of Medicine in St. Louis, who led the

study.

The finding appears in the March 1 issue of the ls of Internal

Medicine.

Celiac disease causes an immune reaction to gluten that interferes with

the ability of the intestine to absorb nutrients, including the calcium

and vitamin D that are essential to the health of bones. A gluten-free

diet improved bone density as well as gastrointestinal symptoms for

people with celiac disease, the researchers reported.

" We believe that the diet allowed the intestines to heal and that

permitted normal absorption of calcium and vitamin D to reverse bone

loss, " Stenson said.

While a severe case of celiac disease produces obvious symptoms such as

weight loss and diarrhea, mild cases often go undiagnosed because they

cause more subtle problems, such as iron deficiency anemia, the

researchers said.

" One of our conclusions is that incidence of celiac disease in patients

with osteoporosis is high enough to justify screening for everybody with

osteoporosis, " Stenson said. " The idea is that if a patient has

osteoporosis as a consequence of celiac disease, the most direct way to

correct their bone loss would be to put them on a gluten-free diet. "

The Washington University report ties in with a Finnish study, released

last year, which found that one in every 99 children tested in a pilot

study had undetected celiac disease, and a study done two years ago at

the University of land that found an incidence of one in 133

children. But both the Finnish and land researchers said the case

for mass screening was still unproven.

" Screening is not something I would recommend for any group based on the

Stenson [Washington University] study, viewed with other data, " said Dr.

Alan L. Buchman, associate professor of medicine at the Northwestern

University Feinberg School of Medicine, who wrote an accompanying

editorial in the journal. " But it is an issue we can't ignore. "

Costs linked to a generalized screening is one important consideration,

he said. " The cost to prevent a single fracture in a patient with celiac

disease and osteoporosis would be $43,000, " Buchman wrote.

" What probably needs to be done is a study that has a large number of

subjects, a cross-section across the nation to determine the incidence, "

Buchman said. Such a study " would take a long time to do and cost a lot

of money, " he added, but " if we screened everybody that would cost

billions of dollars. "

More information

The National Institute of Diabetes and Digestive and Kidney Diseases

(digestive.niddk.nih.gov) offers an overview of celiac disease.