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Impaired Bone Microarchitecture Improves After One Year On Gluten-Free Diet: A Prospective Longitudinal HRpQCT Study in Women With Celiac Disease.
J Bone Miner Res 2017; 32(1):135-142JB

Abstract

We have recently identified a significant deterioration of bone microarchitecture in premenopausal women with newly diagnosed celiac disease (CD) using high-resolution peripheral quantitative computed tomography (HRpQCT). The aim of this work was to assess changes in bone microarchitecture after 1 year on a gluten-free diet (GFD) in a cohort of premenopausal women. We prospectively enrolled 31 consecutive females at diagnosis of CD; 26 of them were reassessed 1 year after GFD. They all underwent HRpQCT scans of distal radius and tibia, areal BMD by DXA, and biochemical tests (bone-specific parameters and CD serology) at both time points. Secondary, we compared 1-year results with those of a control group of healthy premenopausal women of similar age and BMI in order to assess whether the microarchitectural parameters of treated CD patients had reached the values expected for their age. Compared with baseline, the trabecular compartment in the distal radius and tibia improved significantly (trabecular density, trabecular/bone volume fraction [BV/TV] [p < 0.0001], and trabecular thickness [p = 0.0004]). Trabecular number remained stable in both regions. Cortical density increased only in the tibia (p = 0.0004). Cortical thickness decreased significantly in both sites (radius: p = 0.03; tibia: p = 0.05). DXA increased in all regions (lumbar spine [LS], p = 0.01; femoral neck [FN], p = 0.009; ultradistal [UD] radius, p = 0.001). Most parameters continued to be significantly lower than those of healthy controls. This prospective HRpQCT study showed that most trabecular parameters altered at CD diagnosis improved significantly by specific treatment (GFD) and calcium and vitamin D supplementation. However, there were still significant differences with a control group of women of similar age and BMI. In the prospective follow-up of this group of patients we expect to be able to assess whether bone microarchitecture attains levels expected for their age. © 2016 American Society for Bone and Mineral Research.

Authors+Show Affiliations

Instituto de Diagnóstico e Investigaciones Metabólicas (IDIM), Buenos Aires, Argentina. Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina.Instituto de Diagnóstico e Investigaciones Metabólicas (IDIM), Buenos Aires, Argentina. Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina.Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.Instituto de Diagnóstico e Investigaciones Metabólicas (IDIM), Buenos Aires, Argentina.Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.Instituto de Diagnóstico e Investigaciones Metabólicas (IDIM), Buenos Aires, Argentina. Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina.Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina.Instituto de Diagnóstico e Investigaciones Metabólicas (IDIM), Buenos Aires, Argentina. Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina.Instituto de Diagnóstico e Investigaciones Metabólicas (IDIM), Buenos Aires, Argentina. Cátedra de Osteología y Metabolismo Mineral, Universidad del Salvador, Buenos Aires, Argentina.Sección Intestino Delgado, Departamento de Medicina, Hospital de Gastroenterología "Dr. C. Bonorino Udaondo,", Buenos Aires, Argentina. Cátedra de Gastroenterología Facultad de Medicina, Universidad del Salvador, Buenos Aires, Argentina.

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

27447366

Citation

Zanchetta, María Belén, et al. "Impaired Bone Microarchitecture Improves After One Year On Gluten-Free Diet: a Prospective Longitudinal HRpQCT Study in Women With Celiac Disease." Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, vol. 32, no. 1, 2017, pp. 135-142.
Zanchetta MB, Longobardi V, Costa F, et al. Impaired Bone Microarchitecture Improves After One Year On Gluten-Free Diet: A Prospective Longitudinal HRpQCT Study in Women With Celiac Disease. J Bone Miner Res. 2017;32(1):135-142.
Zanchetta, M. B., Longobardi, V., Costa, F., Longarini, G., Mazure, R. M., Moreno, M. L., ... Bai, J. C. (2017). Impaired Bone Microarchitecture Improves After One Year On Gluten-Free Diet: A Prospective Longitudinal HRpQCT Study in Women With Celiac Disease. Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research, 32(1), pp. 135-142. doi:10.1002/jbmr.2922.
Zanchetta MB, et al. Impaired Bone Microarchitecture Improves After One Year On Gluten-Free Diet: a Prospective Longitudinal HRpQCT Study in Women With Celiac Disease. J Bone Miner Res. 2017;32(1):135-142. PubMed PMID: 27447366.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impaired Bone Microarchitecture Improves After One Year On Gluten-Free Diet: A Prospective Longitudinal HRpQCT Study in Women With Celiac Disease. AU - Zanchetta,María Belén, AU - Longobardi,Vanesa, AU - Costa,Florencia, AU - Longarini,Gabriela, AU - Mazure,Roberto Martín, AU - Moreno,María Laura, AU - Vázquez,Horacio, AU - Silveira,Fernando, AU - Niveloni,Sonia, AU - Smecuol,Edgardo, AU - de la Paz Temprano,María, AU - Massari,Fabio, AU - Sugai,Emilia, AU - González,Andrea, AU - Mauriño,Eduardo César, AU - Bogado,Cesar, AU - Zanchetta,José R, AU - Bai,Julio César, Y1 - 2016/10/03/ PY - 2016/01/26/received PY - 2016/07/18/revised PY - 2016/07/20/accepted PY - 2016/7/23/pubmed PY - 2018/1/9/medline PY - 2016/7/23/entrez KW - BONE MICROARCHITECTURE KW - BONE DISORDERS KW - CELIAC DISEASE KW - FRACTURES KW - GLUTEN-FREE DIET KW - HRpQCT KW - OSTEOPOROSIS SP - 135 EP - 142 JF - Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research JO - J. Bone Miner. Res. VL - 32 IS - 1 N2 - We have recently identified a significant deterioration of bone microarchitecture in premenopausal women with newly diagnosed celiac disease (CD) using high-resolution peripheral quantitative computed tomography (HRpQCT). The aim of this work was to assess changes in bone microarchitecture after 1 year on a gluten-free diet (GFD) in a cohort of premenopausal women. We prospectively enrolled 31 consecutive females at diagnosis of CD; 26 of them were reassessed 1 year after GFD. They all underwent HRpQCT scans of distal radius and tibia, areal BMD by DXA, and biochemical tests (bone-specific parameters and CD serology) at both time points. Secondary, we compared 1-year results with those of a control group of healthy premenopausal women of similar age and BMI in order to assess whether the microarchitectural parameters of treated CD patients had reached the values expected for their age. Compared with baseline, the trabecular compartment in the distal radius and tibia improved significantly (trabecular density, trabecular/bone volume fraction [BV/TV] [p < 0.0001], and trabecular thickness [p = 0.0004]). Trabecular number remained stable in both regions. Cortical density increased only in the tibia (p = 0.0004). Cortical thickness decreased significantly in both sites (radius: p = 0.03; tibia: p = 0.05). DXA increased in all regions (lumbar spine [LS], p = 0.01; femoral neck [FN], p = 0.009; ultradistal [UD] radius, p = 0.001). Most parameters continued to be significantly lower than those of healthy controls. This prospective HRpQCT study showed that most trabecular parameters altered at CD diagnosis improved significantly by specific treatment (GFD) and calcium and vitamin D supplementation. However, there were still significant differences with a control group of women of similar age and BMI. In the prospective follow-up of this group of patients we expect to be able to assess whether bone microarchitecture attains levels expected for their age. © 2016 American Society for Bone and Mineral Research. SN - 1523-4681 UR - https://www.unboundmedicine.com/medline/citation/27447366/Impaired_Bone_Microarchitecture_Improves_After_One_Year_On_Gluten_Free_Diet:_A_Prospective_Longitudinal_HRpQCT_Study_in_Women_With_Celiac_Disease_ L2 - https://doi.org/10.1002/jbmr.2922 DB - PRIME DP - Unbound Medicine ER -