User login
WASHINGTON — Take a serious look at the bone health of patients with celiac disease, Dr. Peter Green, director of the Celiac Disease Center at Columbia University, New York, advises.
Patients with this gastrointestinal disease have an increased risk of osteoporosis and fragility fractures because their intestines poorly absorb calcium and vitamin D, and the disorder induces bone-destructive inflammatory and autoimmune responses, he said.
Studies show that up to 50% of men, 40% of postmenopausal women, and 10% of premenopausal women with the disorder have osteoporosis, and up to 30% of these groups have osteopenia.
Yet only 6% of patients with celiac disease will have osteopenia or osteoporosis as their presenting symptom.
Antibodies against tissue transglutaminase (tTG), which contribute to the gluten intolerance that characterizes celiac disease, appear to have a deleterious effect on bone, said Dr. Green. “Tissue transglutaminase is a ubiquitous enzyme that is also present in bone.” Antibodies to tTG are also present in bone and emerging evidence suggests they impair active mineralization.
Studies have shown that a gluten-free diet, which decreases anti-tTG levels, directly correlates with increased bone mass in patients with celiac disease and low bone mineral density, he said at an international symposium sponsored by the National Osteoporosis Foundation.
Proinflammatory circulating cytokines also are increased in celiac disease, and may contribute to decreases in bone density, he said. Comorbidities may also play a role. Secondary hyperparathyroidism is common in patients with celiac disease and may prevent patients from attaining their maximum bone density during childhood. Premature menopause in women and reduced gonadal function in men also can contribute to poor bone health, Dr. Green said.
Bone loss associated with celiac disease results in a significantly increased risk of both peripheral and central fracture, he said. Strict adherence to a gluten-free diet seems to be the best way to boost bone health in these patients, he added.
WASHINGTON — Take a serious look at the bone health of patients with celiac disease, Dr. Peter Green, director of the Celiac Disease Center at Columbia University, New York, advises.
Patients with this gastrointestinal disease have an increased risk of osteoporosis and fragility fractures because their intestines poorly absorb calcium and vitamin D, and the disorder induces bone-destructive inflammatory and autoimmune responses, he said.
Studies show that up to 50% of men, 40% of postmenopausal women, and 10% of premenopausal women with the disorder have osteoporosis, and up to 30% of these groups have osteopenia.
Yet only 6% of patients with celiac disease will have osteopenia or osteoporosis as their presenting symptom.
Antibodies against tissue transglutaminase (tTG), which contribute to the gluten intolerance that characterizes celiac disease, appear to have a deleterious effect on bone, said Dr. Green. “Tissue transglutaminase is a ubiquitous enzyme that is also present in bone.” Antibodies to tTG are also present in bone and emerging evidence suggests they impair active mineralization.
Studies have shown that a gluten-free diet, which decreases anti-tTG levels, directly correlates with increased bone mass in patients with celiac disease and low bone mineral density, he said at an international symposium sponsored by the National Osteoporosis Foundation.
Proinflammatory circulating cytokines also are increased in celiac disease, and may contribute to decreases in bone density, he said. Comorbidities may also play a role. Secondary hyperparathyroidism is common in patients with celiac disease and may prevent patients from attaining their maximum bone density during childhood. Premature menopause in women and reduced gonadal function in men also can contribute to poor bone health, Dr. Green said.
Bone loss associated with celiac disease results in a significantly increased risk of both peripheral and central fracture, he said. Strict adherence to a gluten-free diet seems to be the best way to boost bone health in these patients, he added.
WASHINGTON — Take a serious look at the bone health of patients with celiac disease, Dr. Peter Green, director of the Celiac Disease Center at Columbia University, New York, advises.
Patients with this gastrointestinal disease have an increased risk of osteoporosis and fragility fractures because their intestines poorly absorb calcium and vitamin D, and the disorder induces bone-destructive inflammatory and autoimmune responses, he said.
Studies show that up to 50% of men, 40% of postmenopausal women, and 10% of premenopausal women with the disorder have osteoporosis, and up to 30% of these groups have osteopenia.
Yet only 6% of patients with celiac disease will have osteopenia or osteoporosis as their presenting symptom.
Antibodies against tissue transglutaminase (tTG), which contribute to the gluten intolerance that characterizes celiac disease, appear to have a deleterious effect on bone, said Dr. Green. “Tissue transglutaminase is a ubiquitous enzyme that is also present in bone.” Antibodies to tTG are also present in bone and emerging evidence suggests they impair active mineralization.
Studies have shown that a gluten-free diet, which decreases anti-tTG levels, directly correlates with increased bone mass in patients with celiac disease and low bone mineral density, he said at an international symposium sponsored by the National Osteoporosis Foundation.
Proinflammatory circulating cytokines also are increased in celiac disease, and may contribute to decreases in bone density, he said. Comorbidities may also play a role. Secondary hyperparathyroidism is common in patients with celiac disease and may prevent patients from attaining their maximum bone density during childhood. Premature menopause in women and reduced gonadal function in men also can contribute to poor bone health, Dr. Green said.
Bone loss associated with celiac disease results in a significantly increased risk of both peripheral and central fracture, he said. Strict adherence to a gluten-free diet seems to be the best way to boost bone health in these patients, he added.