Celiac Disease and Osteoporosis: A Review

Celiac disease is a highly-prevalent autoimmune disease characterized by chronic intestinal inflammation. Osteoporosis may be a complication of celiac disease in both the classic presentation where digestive symptoms predominate and in subclinical forms where it may be the initial manifestation of the disease. Various etiopathogenic mechanisms have been reported in osteoporosis which may explain its appearance in celiac disease. There are no studies of sufficient quality evaluating the prevalence of osteoporosis in celiac disease in accordance with World Health Organization densitometric criteria. Although an increased risk of osteoporotic fracture has been reported, bone mineral density testing in patients with celiac disease is not cost-effective. A gluten-free diet increases bone mass to nearly-normal levels and specific treatment for patients with a high risk of osteoporotic fracture is required. There are no studies analyzing the efficacy of anabolic and anti-catabolic drugs in patients with celiac disease.