Celiac Disease and Fracture

[jcc]

Background Earlier studies have suggested that untreated coeliac disease may be associated with osteoporosis, but results are contradictory for the risk of long-term fractures. Aim To study the association between coeliac disease and fractures. Methods We used Cox regresson to examine the future risk of hip fracture and fracture of any type in more than 13 000 individuals with coeliac disease and 65 000 age- and sex-matched reference individuals in a general population-based cohort. Results During follow-up, 1365 first hip fractures and 4847 fractures of any type occurred. Coeliac disease was positively associated with subsequent hip fracture (hazard ratio = 2.1; 95% CI = 1.8-2.4) (in children: hazard ratio = 2.6; 95% CI = 1.1-6.2) and fractures of any type (hazard ratio = 1.4; 95% CI = 1.3-1.5) (in children: hazard ratio = 1.1; 95% CI = 1.0-1.2). The absolute excess risk of hip fractures in children with coeliac disease was 4/100 000 person-years. Incidence ratios for hip fracture in individuals with CD were around two both prior to diagnosis of coeliac disease and afterwards; this risk increase remained 20 years after diagnosis of coeliac disease. Conclusions Individuals with coeliac disease, including children with coeliac disease, may be at increased risk of hip fracture and fracture of any type. Coeliac disease may be positively associated with long-term hip fracture risk.
Coeliac disease and the risk of fractures - a general population-based cohort study. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=17269989&itool=pubmed_DocSum)PMID: 17269989 Feb 2007

[pakisa100]

My children were never tested for cd because we were already on the diet.

However, because of a broken arm at the age of 2 and then, following implementation of a gf diet, increased bone growth... I have no doubt that bones are affected long term in celiacs and possibly 'just gs' people/kids.

'Course you oldies know that I've been looking at growth studies for the last 3 years (bone or bmi). And I think there are other factors involved as well:

Here are some things to consider (after all the abstracts I've read and my own exp. w/ my kids):

Lots of celiac/gs kids suffer fatigue and joint issues (either too loose or too tight). This means that they will often avoid general exercise, which will affect bone density and also impact exercise (like jumping off a box) which also affects bone density (but, I gather, in a different way).

So, it's a two (or more) pronged horn... this bone density issue... starting, of course with gs, possible malabsorption, lack of exercise, (and other things I can't think of this early on a Sunday :rolleyes: ).

Great read! Thanks Cara.

[Hanna]

I just completed it and am in the second level with a weak this and that. 44 years of gluten will do it to anyone.

[OZZ]

Hi Hanna, sorry to hear you are having bone density problems. Yes malabsorptions issues do cause a history of problems.

I was diagnosed with osteopenia but now the information I read is that osteopenia is normal to have after 50 but you wonder...is it really??

When my last daughter was about 5 months I was at a water park and was on an inner tube that floats down little waterfalls. The force of the water twisted my right ring finger and did a major double fracture that took me to 3 hospitals and finally sent me home because no one would touch it. It took 2 pins and a big cast for months before it healed. I asked at the time if I had thin bones and they just laughed. I think they should have tested me back then.

My other thought is can Celiac Disease cause scoliosis? and what about the Osgood-Schlatter Disease and Knee Pain ...big bump on knee thing? Are these problems the result of malabsorption causing vitamin deficiencies causing bone deformities?

[annelb]

My younger son, who had all the GI problems since birth, broke a bone in his leg as a teenager. Was told that it was a break that is usually seen in older people. Too bad that did not set off alarms for either his doctors or me. He also broke his hand at age 10.

I hope his bones are getting stronger now. He is 25 and has been GF for 3 years.
Anne

[JudyLV]

Are these problems the result of malabsorption causing vitamin deficiencies causing bone deformities?

I wonder about that because my younger son has a deformed barrel chest. His bone density tested in range last year. It was checked because he had broken both bones in his forearm. However his bone age was one year younger than his actual age. His vit D was in the 40's which is not too bad (he had been GF for 3 years at this point).

I have read about a deformed chest and ricketts. I am just wondering if the chest deformity started when he was younger before we learned about healing his gut. I am also wondering if as he heals if the deformity will be self correcting to any degree.

--Judy

[lmb3]

Interesting conversation. My son's neuro did a dexaScan on him which showed beginning osteopenia (at age 6!). He has since broken both his arms (at different times) last school year. The first time was in Oct. '05, exactly one month after the DexaScan. The second time was in May '06. The x-rays showed a massive amount of new bone growth all over the place!! :D (We started him on Drisdol - Vit. D in Sept '05) He will probably be getting a repeat DexaScan the next time he goes to the neuro, which is this summer for a follow-up.

Their explanation for the osteopenia was due to malabsorption. Which was very interesting to me since he never had any GI symptoms (his dx is Neurological Celiac Disease). Go figure!!