Celiac Disease Common in Osteoporosis Patients

Healthnotes Newswire (April 14, 2005)- People with osteoporosis (low bone density) are more likely to have celiac disease than those with healthy bones, reports the Archives of Internal Medicine (2005;165:393-9). Celiac disease is an important, though often unrecognized, cause of osteoporosis, and treatment of celiac disease with a gluten-free diet will often reverse bone loss.

Celiac disease is an inflammatory disease caused by an immune-system reaction to gluten grains (wheat, barley, rye, and sometimes oats, spelt, and kamut) that affects the lining of the small intestine and can cause additional problems such as infertility and disorders of the nervous system. In people with celiac disease, gluten (a protein fraction) triggers the formation of antibodies that attack the intestinal lining. These antibodies cause inflammation and degradation of the small intestine's walls, impairing digestion and absorption, and causing a malabsorption syndrome that results in many nutrient deficiencies. People with celiac disease may experience poor digestive function, such as gas, bloating, abdominal pain, and diarrhea, or other symptoms due to resulting deficiencies, such as anemia, weight loss, skin disorders, edema, and numbness.

Osteoporosis is one consequence of poor mineral absorption. Previous studies have found that people with celiac disease frequently have low bone mineral density, which can be restored to normal by eating a gluten-free diet.

The current study enrolled 840 women and men who were being screened for osteoporosis. In addition to measuring bone density, researchers asked participants questions about their history of diarrhea, weight loss, and known celiac disease, and gave blood tests for antibodies associated with celiac disease. Those participants who had positive tests for any of these antibodies were offered intestinal biopsies to look for the changes in the intestinal wall that confirm the diagnosis of celiac disease. At the end of the study, 266 people had osteoporosis and 574 did not. A significantly higher proportion of those with osteoporosis tested positive for all of the antibodies linked to celiac disease. Furthermore, biopsies confirmed the diagnosis of celiac disease in more people with (3.4%) than without (0.2%) osteoporosis.

The results of this study suggest that approximately 1 of every 29 people with osteoporosis has celiac disease, a substantially higher number than is seen in the general population. Identifying celiac disease gives people an important therapeutic tool for treating their osteoporosis: the gluten-free diet. It would be advisable for healthcare providers to offer tests for celiac disease to all people with osteoporosis. A newer blood test- antibodies to tissue transglutaminase- has proven to be a highly accurate screening test for celiac disease, and it is less expensive than the older blood test (endomysial antibodies).