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Celiac disease linked to osteoporosis

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Web extra: Research into celiac disease provides answers

Winnipeg Health Region
Wave, May / June 2010

Women with celiac disease are more likely to develop osteoporosis in later life, according to new research published by a Winnipeg physician.

The study, conducted by Dr. Donald Duerksen, was published in the March issue of the Canadian Journal of Gastroenterology in an article co-authored by Dr. Bill Leslie, a nuclear medicine specialist conducting research into osteoporosis.

Duerksen will present the findings at the Canadian Celiac Association National Conference being held in Winnipeg June 4-6.

Celiac disease is an intestinal disorder that prevents individuals from absorbing nutrients in food. People with celiac disease cannot consume foods with gluten, which is found primarily in wheat, rye and barley.

Duerksen's research shows that, among other things, celiac disease is linked to osteoporosis, a condition that causes brittle bones. People with osteoporosis are often more susceptible to hip fractures and other bonerelated problems.

The province keeps a database of bone density and celiac disease blood tests. "We linked those two so that we could study a large number of people anonymously to examine the possible relationship between the two conditions," says Duerksen. "The research demonstrated that patients who had positive celiac serology (blood testing) had lower bone density," says the gastroenterologist. In fact, the prevalence of osteoporosis was 67.7 per cent in women who tested positive for celiac disease, compared to 44.8 per cent in those who tested negative.

The findings have important implications for prevention and treatment of osteoporosis. For example, women with low bone density may need medication to address the problem. But if they have celiac disease, their small intestine may not be able to absorb the medication. At the same time, their underlying inability to effectively absorb calcium will continue to exacerbate their osteoporosis.

"Bone mineral density is something that needs to be monitored in women diagnosed with celiac disease," adds Duerksen, noting that the inability to absorb calcium can lead to a higher risk for bone-related disease.

Osteoporosis does not happen overnight. It takes years of calcium deprivation to erode bone density. Celiac disease is progressive as well. When people with celiac disease eat products containing even the smallest amount of gluten, their immune system responds by damaging or destroying villi, the tiny fingerlike protrusions that line the small intestine.

"Osteoporosis is one of those conditions that can be relatively silent, so people don't know they've got it until they have a fracture of some sort," notes Duerksen. Symptoms of celiac disease, on the other hand, can vary so widely that the condition can be difficult to diagnose.


About Wave

Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.

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