Coeliac Disease and Bone & Calcium Disorders

Bone and calcium metabolism abnormalities, mainly resulting in osteopoenia and osteoporosis, have long been recognized as a complication of untreated coeliac disease (CD). It has also been reported that, in adults, skeletal disorders may be the only presenting feature of a gluten-sensitive enteropathy (1–3) . The recent availability of simple and reliable biohumoral and instrumental investigations, such as the measurement of bone density by xray absorptiometry (DEXA), has allowed to evaluate the frequency and extent of osteopoenia and/or osteoporosis in coeliac patients during all stages of the disease, from diagnosis to follow-up (4) . Although bone turnover is also affected by genetic and environmental factors (ins 5 ) , the majority of authors agree that the introduction of a gluten-free diet (GFD) in CD patients results in a significant clinical and metabolic improvement and, in some cases, avoids the progressive deterioration of existing bone alterations (6,7,8) . Therefore, it can be easily understood that identification of subjects with untreated CD might play a preventing role, since bone demineralization is associated with a higher risk of fractures.