Osteoporosis in celiac disease

[Kofi]

Effects of Celiac Disease on Bone Mineral Density Are Pronounced in
Lumbar Spine Than Femoral Neck

ScienceDaily (May 26, 2011) ã Patients with celiac disease are more than
4.5 times more likely to develop osteoporosis compared to healthy people
in an age and gender matched cohort with no identifiable risk factors
for osteoporosis, according to a study presented at the EULAR 2011
Annual Congress.

The British study of 1,030 people compares the extent of bone mineral
density (BMD)* loss -- a common measure of osteoporosis -- in two
physical locations in the body. The results demonstrated that the mean
BMD of the lumbar spine in patients with coeliac disease was
significantly different when compared to the control group (1.79 (95% CI
1.32, 2.44)), however not for the femoral neck vs. control (1.52 (95% CI
0.86, 2.67)).

"This is the first study that compares the extent of BMD loss at the
lumbar spine and femoral neck in an age and sex matched cohort, and
demonstrates that the detrimental effects of coeliac disease are most
pronounced in the lower back compared to the hip joint," said Mr Oldroyd
of Lancaster University School of Medicine. "These findings may be due
to the fact that the bone in the lumbar spine is spongy, less dense and
weaker in comparison to the femoral neck, causing it to be more
susceptible to the detrimental effects of coeliac disease. There is
greater research required to determine why this effect is seen and
whether it can have future implications for treatment."

The authors from Lancaster and the Liverpool area collected results of
DEXA scans (used to measure BMD) from 1,030 patients with coeliac
disease between June 2004 and September 2007. Scan results of the lumbar
spine and femoral neck of patients with coeliac disease were compared to
a healthy, age and gender matched cohort, with no identifiable risk
factors for osteoporosis. Logistic regression analysis was used to
investigate the association between coeliac disease and BMD results for
the lumbar spine and femoral neck in the lowest tertile of the whole
study cohort.

*BMD refers to the amount of matter per cubic centimeter of bones.
Measurements are most commonly made over the lumbar spine and over the
upper part of the hip. Average density is around 1500 kg m-3. BMD is
often measured with a t-score, the number of standard deviations above
or below the mean for a healthy 30 year old adult of the same sex and
ethnicity as the patient. Average t-scores are as follows:

T-score:

* Normal: Less than 1 standard deviation (SD) below the young adult
reference range (more than -1)
* Low bone mass (osteopenia): 1 to 2.5 SDs below the young adult
reference range (-1 to -2.5)
* Osteoporosis: 2.5 or more SDs below the young adult reference range
(-2.5 or less)

<http://www.sciencedaily.com/releases/2011/05/110526064753.htm>