Dual X-ray absorptiometry-derived bone status indexes and videocapsule intestinal aspects in celiac disease.
Journal
European journal of gastroenterology & hepatology
ISSN: 1473-5687
Titre abrégé: Eur J Gastroenterol Hepatol
Pays: England
ID NLM: 9000874
Informations de publication
Date de publication:
01 10 2023
01 10 2023
Historique:
medline:
5
9
2023
pubmed:
14
8
2023
entrez:
14
8
2023
Statut:
ppublish
Résumé
Celiac disease is a risk factor for osteopenia and osteoporosis. Our aim was to evaluate the possible correlation between villous atrophy extension and dual-energy X-ray absorptiometry (DXA)-derived parameters of bone status. We have retrospectively analyzed data of 47 celiac patients (36 women, 52 ± 14 years of age) who underwent video capsule endoscopy and DXA scans within 1 year of interval from 2006 to 2019. Quantitative, qualitative and geometric DXA parameters were collected only from the most recent DXA measurements. . Patients were divided into three categories; the first included those with no lesions at video capsule endoscopy (23 patients), the second those with typical lesions (mucosal atrophy, mosaicism and scalloping) in less than one-third of the small bowel (SB) (16 patients) and the third those with typical lesions in more than one-third of the SB (7 patients). In the third group, bone mineral density seemed to be lower in both the lumbar spine and the hip ( P = 0.026 and P = 0.011, respectively). The deterioration of bone structure in patients with severe and extended SB atrophy was statistically significant ( P = 0.032). Furthermore, bone density, structure and geometry did not correlate with the duration of the gluten-free diet. Notably, autoimmune comorbidities did not affect DXA results. Neither endoscopic nor histological atrophy itself can explain the deterioration of bone mineralization and structure, whereas atrophy extension appeared to be responsible for bone impairment.
Sections du résumé
BACKGROUND AND AIM
Celiac disease is a risk factor for osteopenia and osteoporosis. Our aim was to evaluate the possible correlation between villous atrophy extension and dual-energy X-ray absorptiometry (DXA)-derived parameters of bone status.
METHODS
We have retrospectively analyzed data of 47 celiac patients (36 women, 52 ± 14 years of age) who underwent video capsule endoscopy and DXA scans within 1 year of interval from 2006 to 2019. Quantitative, qualitative and geometric DXA parameters were collected only from the most recent DXA measurements.
RESULTS
. Patients were divided into three categories; the first included those with no lesions at video capsule endoscopy (23 patients), the second those with typical lesions (mucosal atrophy, mosaicism and scalloping) in less than one-third of the small bowel (SB) (16 patients) and the third those with typical lesions in more than one-third of the SB (7 patients). In the third group, bone mineral density seemed to be lower in both the lumbar spine and the hip ( P = 0.026 and P = 0.011, respectively). The deterioration of bone structure in patients with severe and extended SB atrophy was statistically significant ( P = 0.032). Furthermore, bone density, structure and geometry did not correlate with the duration of the gluten-free diet. Notably, autoimmune comorbidities did not affect DXA results.
CONCLUSION
Neither endoscopic nor histological atrophy itself can explain the deterioration of bone mineralization and structure, whereas atrophy extension appeared to be responsible for bone impairment.
Identifiants
pubmed: 37577844
doi: 10.1097/MEG.0000000000002616
pii: 00042737-990000000-00213
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1117-1122Informations de copyright
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.
Références
Zingone F, Maimaris S, Auricchio R, Caio GPI, Carroccio A, Elli L, et al. Guidelines of the Italian societies of gastroenterology on the diagnosis and management of coeliac disease and dermatitis herpetiformis. Dig Liver Dis 2022; 54:1304–1319.
Chetcuti Zammit S, Sanders DS, Sidhu R. Bone mineral density in patients with celiac disease: a further association with extent of disease on capsule endoscopy. J Clin Gastroenterol 2020; 54:294–295.
Di Stefano M, Bergonzi M, Benedetti I, De Amici M, Torre C, Brondino N, et al. Alterations of inflammatory and matrix production indices in celiac disease with low bone mass on long-term gluten-free diet. J Clin Gastroenterol 2019; 53:e221–e226.
Glaser DL, Kaplan FS. Osteoporosis. Definition and clinical presentation. Spine (Phila Pa 1976) 1997; 22(Suppl 24):12S–16S.
Karaguzel G, Holick MF. Diagnosis and treatment of osteopenia. Rev Endocr Metab Disord 2010; 11:237–251.
Klibanski A, Adams-Campbell L, Bassford T, et al. Osteoporosis prevention, diagnosis, and therapy. JAMA 2001; 285:785–795.
Kanis JA, McCloskey EV, Johansson H, Cooper C, Rizzoli R, Reginster JY; Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the Committee of Scientific Advisors of the International Osteoporosis Foundation (IOF). European guidance for the diagnosis and management of osteoporosis in postmenopausal women. Osteoporos Int 2013; 24:23–57.
Silva BC, Broy SB, Boutroy S, Schousboe JT, Shepherd JA, Leslie WD. Fracture risk prediction by non-BMD DXA measures: the 2015 ISCD official positions part 2: trabecular bone score. J Clin Densitom 2015; 18:309–330.
Keaveny AP, Freaney R, McKenna MJ, Masterson J, O’Donoghue DP. Bone remodeling indices and secondary hyperparathyroidism in celiac disease. Am J Gastroenterol 1996; 91:1226–1231.
Al-Toma A, Volta U, Auricchio R, Castillejo G, Sanders DS, Cellier C, et al. European Society for the Study of Coeliac Disease (ESsCD) guideline for coeliac disease and other gluten-related disorders. United Eur Gastroenterol J 2019; 7:583–613.
Pennazio M, Rondonotti E, Despott EJ, Dray X, Keuchel M, Moreels T, et al. Small-bowel capsule endoscopy and device-assisted enteroscopy for diagnosis and treatment of small-bowel disorders: European Society of Gastrointestinal Endoscopy (ESGE) Guideline – Update 2022. Endoscopy 2023; 55:58–95.
Perez-Cuadrado-Robles E, Lujan-Sanchis M, Elli L, Juanmartinena-Fernandez J-F, Garcia-Lledo J, Ruano-Diaz L, et al.; Enteroscopy and Capsule Endoscopy Spanish Society Group of the Spanish Society of Digestive Endoscopy (SEED). Role of capsule endoscopy in alarm features and non-responsive celiac disease: a European multicenter study. Dig Endosc 2018; 30:461–466.
Oberhuber G, Granditsch G, Vogelsang H. The histopathology of coeliac disease: time for a standardized report scheme for pathologists. Eur J Gastroenterol Hepatol 1999; 11:1185–1194.
Elli L, Zini E, Tomba C, Bardella MT, Bosari S, Conte D, et al. Histological evaluation of duodenal biopsies from coeliac patients: the need for different grading criteria during follow-up. BMC Gastroenterol 2015; 15:133–140.
Elli L, Marinoni B, Sidhu R, Bojarski C, Branchi F, Tontini GE, et al. Nomenclature and definition of atrophic lesions in small bowel capsule endoscopy: a delphi consensus statement of the International CApsule endoscopy REsearch (I-CARE) Group. Diagnostics (Basel, Switzerland) 2022; 12:1704–1713.
Nuti R, Brandi ML, Checchia G, Di Munno O, Dominguez L, Falaschi P, et al. Guidelines for the management of osteoporosis and fragility fractures. Intern Emerg Med 2019; 14:85–102.
Elli L, Bascuñán K, Di Lernia L, Bardella MT, Doneda L, Soldati L, et al. Safety of occasional ingestion of gluten in patients with celiac disease: a real-life study. BMC Med 2020; 18:42–50.
Rej A, Elli L, Sanders DS. Persisting villous atrophy and adherence in celiac disease: what does the patient want? What should a clinician advise? Am J Gastroenterol 2021; 116:946–948.
Valdimarsson T, Löfman O, Toss G, Ström M. Reversal of osteopenia with diet in adult coeliac disease. Gut 1996; 38:322–327.
Meyer D, Stavropolous S, Diamond B, Shane E, Green PHR. Osteoporosis in a north American adult population with celiac disease. Am J Gastroenterol 2001; 96:112–119.
Fickling WE, McFarlane XA, Bhalla AK, Robertson DAF. The clinical impact of metabolic bone disease in coeliac disease. Postgrad Med J 2001; 77:33–36.
Walters JRF, Banks LM, Butcher GP, Fowler CR. Detection of low bone mineral density by dual energy X ray absorptiometry in unsuspected suboptimally treated coeliac disease. Gut 1995; 37:220–224.
Jafri MR, Nordstrom CW, Murray JA, Van Dyke CT, Dierkhising RA, Zinsmeister AR, et al. Long-term fracture risk in patients with celiac disease: a population-based study in Olmsted County, Minnesota. Dig Dis Sci 2008; 53:964–971.
Ludvigsson JF, Michaelsson K, Ekbom A, Montgomery SM. Coeliac disease and the risk of fractures – a general population-based cohort study. Aliment Pharmacol Ther 2007; 25:273–285.
García-Manzanares A, Tenias JM, Lucendo AJ. Bone mineral density directly correlates with duodenal Marsh stage in newly diagnosed adult celiac patients. Scand J Gastroenterol 2012; 47:927–936.
Pasternack C, Koskinen I, Hervonen K, Kaukinen K, Järvelin J, Reunala T, et al. Risk of fractures in dermatitis herpetiformis and coeliac disease: a register-based study. Scand J Gastroenterol 2019; 54:843–848.
Zanchetta MB, Longobardi V, Bai JC. Bone and celiac disease. Curr Osteoporos Rep 2016; 14:43–48.
LeBoff MS, Cobb H, Gao LY, Hawkes W, Yu-Yahiro J, Kolatkar NS, et al. Celiac disease is not increased in women with hip fractures and low vitamin D levels. J Nutr Health Aging 2013; 17:562–565.
Topa M, Sanders DS, Elli L. Biomarkers for the diagnosis and monitoring of celiac disease: can you count on me? Curr Opin Gastroenterol 2022; 38:263–269.