Keogh Institute for Medical Research, Nedlands, WA, Australia.
Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.
Climacteric. 2020 Dec;23(6):559-565. doi: 10.1080/13697137.2020.1816957. Epub 2020 Sep 22.
Malabsorption due to celiac disease (CD) may contribute to postmenopausal osteoporosis. This study aimed to survey participants with CD regarding their bone density, fractures, and bone-preserving medications; to compare tolerance of bone-preserving medications in participants with and without CD; and to review the evidence for CD screening and osteoporosis therapies in the setting of CD. We recruited 131 participants with CD and 102 participants without CD. Of those with CD, 87% were diagnosed in adulthood and 40% had no recognized gastrointestinal symptoms. In 21% CD was diagnosed after the diagnosis of osteoporosis and in 9% after a fracture. No difference was found in the tolerability of bone medications between participants with CD and those without. Review of the literature found that, although monitoring of bone health is recommended for patients with CD, screening for CD is not generally accepted for patients with osteoporosis, although studies of the prevalence of CD in osteoporosis had incomplete ascertainment methods. There is a lack of well-conducted studies and therefore insufficient data for the efficacy and tolerability of bone medication in CD. In conclusion, both CD and menopause lead to bone loss. Identifying CD in postmenopausal women should lead to modification of osteoporosis management.
由于乳糜泻（CD）导致的吸收不良可能导致绝经后骨质疏松症。本研究旨在调查 CD 患者的骨密度、骨折和保骨药物情况；比较 CD 患者和非 CD 患者对保骨药物的耐受性；并回顾 CD 筛查和骨质疏松症治疗的证据。我们招募了 131 名 CD 患者和 102 名非 CD 患者。其中 87%的患者在成年后被诊断出患有 CD，40%的患者没有明显的胃肠道症状。21%的 CD 在骨质疏松症诊断后被诊断出，9%在骨折后被诊断出。CD 患者和非 CD 患者对保骨药物的耐受性没有差异。文献回顾发现，尽管建议对 CD 患者进行骨健康监测，但一般不接受对骨质疏松症患者进行 CD 筛查，尽管对骨质疏松症中 CD 患病率的研究采用了不完全的确定方法。目前缺乏精心设计的研究，因此关于 CD 患者使用骨药物的疗效和耐受性的数据不足。总之，CD 和绝经都会导致骨丢失。绝经后妇女中 CD 的发现应导致骨质疏松症管理的改变。
