Vnitr Lek 2014, 60(7-8):601-606

Osteoporosis and bone alterations in celiac disease in adults

Iva Hoffmanová^*, Michal Anděl

II. interní klinika 3. LF UK a FN Královské Vinohrady, Praha, přednosta prof. MUDr. Michal Anděl, CSc.

Both celiac disease and osteoporosis are common diseases which are considered an emerging problem in medicine. Celiac disease is a condition at high risk for secondary osteoporosis. Osteoporosis or osteopenia are typically present in untreated adult symptomatic celiac disease with an overt malabsorption syndrome, but is found in about 50 % in suboptimally treated celiac patients, subclinical patients and asymptomatic adult celiac patients, too. Etiology of pathologic bone alteration in celiac disease is multifactorial; however, two main mechanisms are involved: intestinal malabsorption and chronic inflammation. The evaluation of bone mineral metabolism (total calcium/albumin, 25-OH vitamin D₃ and parathormone levels in serum) and bone mineral density (densitometry) is recommended in the clinical management of celiac patients. Many studies have demonstrated that bone mineral density values in adults show a good improvement in the first period after the institution of gluten-free diet, the improvement is then unsatisfactory and treatment with a mineral-active drug should probably be considered.

Keywords: bone mineral density; bone mineral metabolism; celiac disease; densitometry; gluten-free diet; osteoporosis; intestinal inflamation; malabsorption

Received: April 28, 2014; Accepted: May 26, 2014; Published: July 1, 2014  Show citation