CONTEXT: Osteoporosis is often a presenting sign of celiac disease (CD). Whether skeletal fragility in CD is associated with microarchitectural abnormalities is not known. OBJECTIVE: The objective of the study was to evaluate microarchitecture and biomechanical properties of bone in CD. DESIGN: This was a case-control study. SETTING: The study was conducted at a university hospital outpatient facility. PATIENTS: Patients included premenopausal women with newly diagnosed CD (n = 33) and healthy controls (n = 33). MAIN OUTCOME MEASURES: Areal bone mineral density by dual-energy x-ray absorptiometry was measured as was trabecular and cortical volumetric bone mineral density (vBMD) and microarchitecture by high-resolution peripheral computed tomography of the distal radius and tibia. Whole-bone stiffness estimated by finite element analysis. PTH, 25-hydroxyvitamin D, and bone turnover markers were also measured. RESULTS: Groups had similar age, race, and body mass index. Both groups had sufficient 25-hydroxyvitamin D and normal calcium and PTH. Areal bone mineral density was lower in CD. By high-resolution peripheral computed tomography, CD had lower trabecular vBMD, fewer, more widely, and irregularly spaced trabeculae at both the radius and tibia (8%-33%). At the tibia, they also had lower total density (8%) and thinner cortices (10%). Whole-bone stiffness and failure load were lower (11%-21%) in CD at both sites. Biomechanical deficits were associated with trabecular abnormalities. CONCLUSIONS: Women with CD had abnormal vBMD and microarchitecture at both the radius and tibia. Trabecular bone was preferentially affected. These deficits were associated with lower estimates of skeletal strength. These findings suggest a potential structural mechanism for skeletal fragility in CD and support further research into the pathogenesis of fracture in this population.
CONTEXT: Osteoporosis is often a presenting sign of celiac disease (CD). Whether skeletal fragility in CD is associated with microarchitectural abnormalities is not known. OBJECTIVE: The objective of the study was to evaluate microarchitecture and biomechanical properties of bone in CD. DESIGN: This was a case-control study. SETTING: The study was conducted at a university hospital outpatient facility. PATIENTS: Patients included premenopausal women with newly diagnosed CD (n = 33) and healthy controls (n = 33). MAIN OUTCOME MEASURES: Areal bone mineral density by dual-energy x-ray absorptiometry was measured as was trabecular and cortical volumetric bone mineral density (vBMD) and microarchitecture by high-resolution peripheral computed tomography of the distal radius and tibia. Whole-bone stiffness estimated by finite element analysis. PTH, 25-hydroxyvitamin D, and bone turnover markers were also measured. RESULTS: Groups had similar age, race, and body mass index. Both groups had sufficient 25-hydroxyvitamin D and normal calcium and PTH. Areal bone mineral density was lower in CD. By high-resolution peripheral computed tomography, CD had lower trabecular vBMD, fewer, more widely, and irregularly spaced trabeculae at both the radius and tibia (8%-33%). At the tibia, they also had lower total density (8%) and thinner cortices (10%). Whole-bone stiffness and failure load were lower (11%-21%) in CD at both sites. Biomechanical deficits were associated with trabecular abnormalities. CONCLUSIONS:Women with CD had abnormal vBMD and microarchitecture at both the radius and tibia. Trabecular bone was preferentially affected. These deficits were associated with lower estimates of skeletal strength. These findings suggest a potential structural mechanism for skeletal fragility in CD and support further research into the pathogenesis of fracture in this population.
Authors: Adi Cohen; X Sherry Liu; Emily M Stein; Donald J McMahon; Halley F Rogers; Jeanette Lemaster; Robert R Recker; Joan M Lappe; X Edward Guo; Elizabeth Shane Journal: J Clin Endocrinol Metab Date: 2009-10-16 Impact factor: 5.958
Authors: L Joseph Melton; B Lawrence Riggs; G Harry van Lenthe; Sara J Achenbach; Ralph Müller; Mary L Bouxsein; Shreyasee Amin; Elizabeth J Atkinson; Sundeep Khosla Journal: J Bone Miner Res Date: 2007-09 Impact factor: 6.741
Authors: Elisabeth Sornay-Rendu; Jose-Luis Cabrera-Bravo; Stéphanie Boutroy; Françoise Munoz; Pierre D Delmas Journal: J Bone Miner Res Date: 2009-04 Impact factor: 6.741
Authors: Mohammed R Jafri; Charles W Nordstrom; Joseph A Murray; Carol T Van Dyke; Ross A Dierkhising; Alan R Zinsmeister; Lee J Melton Journal: Dig Dis Sci Date: 2007-10-13 Impact factor: 3.199
Authors: Rachele Ciccocioppo; Peter Kruzliak; Giuseppina C Cangemi; Miroslav Pohanka; Elena Betti; Eugenia Lauret; Luis Rodrigo Journal: Nutrients Date: 2015-10-22 Impact factor: 5.717
Authors: Alejandro Martínez-Rodríguez; Daniela Alejandra Loaiza-Martínez; Javier Sánchez-Sánchez; Pablo J Marcos-Pardo; Soledad Prats; Fernando Alacid; Jacobo A Rubio-Arias Journal: Int J Environ Res Public Health Date: 2020-01-15 Impact factor: 3.390
Authors: Gloria Galli; Edith Lahner; Laura Conti; Gianluca Esposito; Maria Carlotta Sacchi; Bruno Annibale Journal: United European Gastroenterol J Date: 2018-06-12 Impact factor: 4.623