By Van Waffle
Summary: Patients with celiac disease are at increased risk of bone fracture. Previous research connected this risk with osteoporosis and decreased bone density and determined that it persists even when patients adopt a gluten-free diet. This American and Swedish study was the first to explore whether fractures relate to persistent intestinal damage in patients attempting a gluten-free diet.
The data came from medical histories of more than 7,000 Swedish celiac disease patients between 1969 and 2008. The study compared patients whose intestines healed with those showing incomplete healing despite treatment. All patients, healed or not, were just as fracture-prone overall. However, hip fractures alone showed a clear connection: risk increased with more severe flattening of the villi, tiny intestinal projections that are damaged by celiac disease.
Conclusion: The large size of this historical data set indicates a strong link but cannot provide insight about the cause. Current clinical investigation is required to understand how persistent gut tissue damage is connected with broken hips. Bone fractures present a serious consequence of celiac disease. Hip fractures are particularly detrimental to a patient’s health and quality of life. A follow-up biopsy showing persistent flattening of the villi should raise concern about possible osteoporosis, especially in older patients.
 “Persistent mucosal damage and risk of fracture in celiac disease”, Lebwohl B, Michaëlsson K, Green PHR, Ludvigsson JF, #The Journal of Clinical Endocrinology & Metabolism#, 2014 Feb; 99(2):609-16.