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Effect of treatment on bone mass, mineral metabolism, and body composition in untreated celiac disease patients.
Am J Gastroenterol 1997; 92(2):313-8AJ

Abstract

BACKGROUND/AIMS

Osteopenia is a common complication of celiac disease. The aims of this study were to evaluate whether treatment produces bone remineralization and whether calcium and vitamin D supplementation are necessary to reduce osteopenia.

METHODS

Bone mineral density and biochemical parameters of bone and mineral metabolism were measured in 14 newly diagnosed adult celiac disease patients. All patients were treated with a gluten-free diet and were randomized to receive diet only (n = 7) or diet plus calcium (1.0 g/day) and vitamin D (32,000 IU/wk) supplementation (n = 7). Bone density was measured at baseline and at 6 and 12 months of follow-up. Tests for biochemical determinations were repeated every 3 months.

RESULTS

At diagnosis, 11 patients had evidence of osteopenia (> 1 SD below normality) in the spine and total skeleton. After 12 months of gluten restriction, overall bone mass had increased 5.0% (p < 0.01) in the lumbar spine and 5.0% (p < 0.002) in the total skeleton. When one only considers those 11 patients who strictly followed gluten restriction, bone density increased 8.4% in the lumbar spine and 7.7% in the total skeleton. Remineralization occurred throughout the skeleton but was more pronounced in the axial than in the peripheral skeleton. The increase in bone mass was independent of age or menopause. Remineralization in patients treated with diet only was similar to that of patients treated with diet and supplements. Basal biochemical parameters showed a high bone turnover with secondary hyperparathyroidism. Treatment induced a decrease in bone turnover activity. However, a complete restoration of biochemical parameters was not achieved.

CONCLUSIONS

Strict gluten avoidance promoted a significant increase in bone mineral density. However, values still remain markedly low after 1 yr in several patients. Although calcium and vitamin D supplementation did not provide additional benefit to that obtained by diet alone in the doses administered, our results do not preclude a possible effect of vitamin D at higher dose.

Authors+Show Affiliations

Clinical Department, Hospital de Gastroenterología Dr. Carlos Bonorino Udaondo, Salvador University, Buenos Aires, Argentina.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9040213

Citation

Mautalen, C, et al. "Effect of Treatment On Bone Mass, Mineral Metabolism, and Body Composition in Untreated Celiac Disease Patients." The American Journal of Gastroenterology, vol. 92, no. 2, 1997, pp. 313-8.
Mautalen C, González D, Mazure R, et al. Effect of treatment on bone mass, mineral metabolism, and body composition in untreated celiac disease patients. Am J Gastroenterol. 1997;92(2):313-8.
Mautalen, C., González, D., Mazure, R., Vázquez, H., Lorenzetti, M. P., Maurino, E., ... Bai, J. C. (1997). Effect of treatment on bone mass, mineral metabolism, and body composition in untreated celiac disease patients. The American Journal of Gastroenterology, 92(2), pp. 313-8.
Mautalen C, et al. Effect of Treatment On Bone Mass, Mineral Metabolism, and Body Composition in Untreated Celiac Disease Patients. Am J Gastroenterol. 1997;92(2):313-8. PubMed PMID: 9040213.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of treatment on bone mass, mineral metabolism, and body composition in untreated celiac disease patients. AU - Mautalen,C, AU - González,D, AU - Mazure,R, AU - Vázquez,H, AU - Lorenzetti,M P, AU - Maurino,E, AU - Niveloni,S, AU - Pedreira,S, AU - Smecuol,E, AU - Boerr,L A, AU - Bai,J C, PY - 1997/2/1/pubmed PY - 1997/2/1/medline PY - 1997/2/1/entrez SP - 313 EP - 8 JF - The American journal of gastroenterology JO - Am. J. Gastroenterol. VL - 92 IS - 2 N2 - BACKGROUND/AIMS: Osteopenia is a common complication of celiac disease. The aims of this study were to evaluate whether treatment produces bone remineralization and whether calcium and vitamin D supplementation are necessary to reduce osteopenia. METHODS: Bone mineral density and biochemical parameters of bone and mineral metabolism were measured in 14 newly diagnosed adult celiac disease patients. All patients were treated with a gluten-free diet and were randomized to receive diet only (n = 7) or diet plus calcium (1.0 g/day) and vitamin D (32,000 IU/wk) supplementation (n = 7). Bone density was measured at baseline and at 6 and 12 months of follow-up. Tests for biochemical determinations were repeated every 3 months. RESULTS: At diagnosis, 11 patients had evidence of osteopenia (> 1 SD below normality) in the spine and total skeleton. After 12 months of gluten restriction, overall bone mass had increased 5.0% (p < 0.01) in the lumbar spine and 5.0% (p < 0.002) in the total skeleton. When one only considers those 11 patients who strictly followed gluten restriction, bone density increased 8.4% in the lumbar spine and 7.7% in the total skeleton. Remineralization occurred throughout the skeleton but was more pronounced in the axial than in the peripheral skeleton. The increase in bone mass was independent of age or menopause. Remineralization in patients treated with diet only was similar to that of patients treated with diet and supplements. Basal biochemical parameters showed a high bone turnover with secondary hyperparathyroidism. Treatment induced a decrease in bone turnover activity. However, a complete restoration of biochemical parameters was not achieved. CONCLUSIONS: Strict gluten avoidance promoted a significant increase in bone mineral density. However, values still remain markedly low after 1 yr in several patients. Although calcium and vitamin D supplementation did not provide additional benefit to that obtained by diet alone in the doses administered, our results do not preclude a possible effect of vitamin D at higher dose. SN - 0002-9270 UR - https://www.unboundmedicine.com/medline/citation/9040213/Effect_of_treatment_on_bone_mass_mineral_metabolism_and_body_composition_in_untreated_celiac_disease_patients_ L2 - http://www.diseaseinfosearch.org/result/1186 DB - PRIME DP - Unbound Medicine ER -