Celiac disease is an autoimmune disease of the digestive tract. When people with this disease eat foods containing gluten, little bulges occur in the small intestine. It results in abdominal pain, bloating, gas, diarrhea, fatigue, and other unpleasant symptoms. In addition, the damaged intestine will have problems absorbing nutrients from food. Low absorption of nutrients like calcium and vitamin D can affect bone growth and repair. Overtime this can contribute to osteoporosis.
Although celiac disease is known to reduce vitamin D and calcium levels in the blood, the link between celiac and bone damage itself is not clear. Researchers wanted to examine this relationship. The study, published in the Journal of Clinical Endocrinology and Metabolism, found that celiac disease was associated with an increased risk of bone fractures.
The systematic review included 16 observational studies in which bone fracture outcomes were compared in individuals with and without celiac disease in order to evaluate the association between celiac disease and the risk of bone fractures.
A meta-analysis of the studies revealed that celiac disease is associated with an increased risk of any fracture as well as an increased risk of hip fractures. There was no significant difference in the risk of fractures of the arms, hands, legs, and feet. .
A meta-analysis is a mathematical method that combines the results of several smaller studies in order to improve the reliability of the results. Studies chosen for inclusion in a meta-analysis must be similar in a number characteristics in order to accurately combine their results. In this analysis, the observational studies were not similar enough to be combined and compared, making the end result less reliable. The trials were also observational studies which can show some potential link between two factors but cannot show cause and effect. So while this study showed a potential connection between celiac disease and increased risk of bone fractures, it can not confirm that celiac was the cause.
If you have celiac disease, talk to your doctor about health risks associated with celiac. Finding an effective treatment while maintaining a healthy diet may help decrease your risk of secondary issues. Talk to your doctor if you have concerns about your bone health. Your doctor may recommend taking some steps to help protect your bones such as:
Heikkilä K, Pearce J, et al. Celiac disease and bone fractures: a systematic review and meta-analysis. J Clin Endocrinol Metab. 2015 Jan;100(1):25-34.
Osteoporosis causes and risk factors. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated October 12, 2015. Accessed November 10, 2015.
Last reviewed November 2015 by Michael Woods, MD