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Study Reveals Celiac Disease and Osteoporosis Link

Human Skeletal
A study has shown that celiac disease sufferers could develop osteoporosis because their immune system attacks their bone tissue.

Osteoporosis is a bone disease that weakens bones, making them more susceptible to fractures, especially the bones in the spine, hip and wrist. Osteoporosis is a silent disease, there are usually no symptoms until a bone is fractured. Exercise and a diet rich in calcium and vitamin D can help to prevent osteoporosis.

Celiac disease (CD) is a digestive condition that that affects 1 in 100 people and damages the small intestine, interfering with absorption of nutrients from food. People who have CD cannot tolerate gluten, a protein in wheat, rye, and barley. The only treatment for CD is a gluten-free diet.

It is the first time an autoimmune response, a condition whereby the body can attack itself, has been shown to cause damage to bones directly.

Researchers studied a protein called osteoprotegerin (OPG) in people with celiac disease. In healthy people, OPG plays a crucial role in maintaining bone health by controlling the rate at which bone tissue is removed. Twenty per cent of celiac patients produce antibodies that attack the OPG protein and stop it working properly. This results in rapid bone destruction and severe osteoporosis.

It was previously thought that osteoporosis, a known complication of CD, develops in celiac patients because they cannot properly absorb calcium and vitamin D from their diet. Both nutrients are essential for healthy bone development.

The researchers found that this new form of osteoporosis did not respond to calcium and vitamin D supplements.

Professor Stuart Ralston, who led the team, said: "Testing for these antibodies could make a real and important difference to the lives of people with CD by alerting us to the risk of osteoporosis and helping us find the correct treatment for them."
References:
1. Stuart Ralston, et al. Osteoporosis Associated with Neutralizing Autoantibodies against Osteoprotegerin. The New England Journal of Medicine. Volume 361:1459-1465. October 8, 2009, Number 15.
2. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
3. National Digestive Diseases Information Clearinghouse.

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