The other side of celiac disease – assessment of bone mineral density and body composition in patients with celiac disease

Introduction
Decreased bone mineral density (BMD) is one of the most frequent extraintestinal symptoms of celiac disease (CD).

Aim
The study aimed to investigate BMD, body composition, 25(OH)D, and ionised calcium blood parameters, and to compare them between women with CD and healthy individuals.

Material and methods
The study covered 30 adult women with CD and 28 healthy controls. Densitometric measurements of the lumbar spine (L1–L4) and femoral neck (FN) were conducted using dual-energy X-ray absorptiometry (DXA). Body mass was measured with the use of the bioimpedance method. Furthermore, serum 25(OH)D and ionised calcium concentration were determined. All patients completed a questionnaire referring to vitamin D and calcium supplementation.

Results
Significant differences were found between the groups for body mass, body mass index (BMI), BMD, T-score, and Z-score of the FN, BMD, and T-score of the L1-L4, and 25(OH)D concentration. Osteopaenia affected 23.33% (n = 7) and 36.67% (n = 11) of patients in the FN and L1-L4, respectively, and osteoporosis in L1-L4 affected 13.33% (n = 4) of patients with CD. There were no cases of osteoporosis in FN. CD patients more often declared vitamin D and calcium supplementation than healthy participants. None of the patients reported a history of fractures.

Conclusions
Although patients with CD more often declare supplementing vitamin D and calcium, the prevalence of osteopaenia and osteoporosis is higher in this group compared to healthy controls. At the same time, patients with CD present with lower body mass, BMI, fat tissue, muscle mass, and fat-free mass and higher 25(OH)D concentration.