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Risk of low bone mineral density and low body mass index in patients with non-celiac wheat-sensitivity: a prospective observation study.

Carroccio A, Soresi M, D'Alcamo A, Sciumè C, Iacono G, Geraci G, Brusca I, Seidita A, Adragna F, Carta M, Mansueto P - BMC Med (2014)

Bottom Line: Values of daily dietary calcium intake in NCWS patients were significantly lower than in IBS controls.An elevated frequency of bone mass loss in NCWS patients was found; this was related to low BMI and was more frequent in patients with NCWS associated with other food sensitivity.A low daily intake of dietary calcium was observed in patients with NCWS.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Non-celiac gluten sensitivity (NCGS) or 'wheat sensitivity' (NCWS) is included in the spectrum of gluten-related disorders. No data are available on the prevalence of low bone mass density (BMD) in NCWS. Our study aims to evaluate the prevalence of low BMD in NCWS patients and search for correlations with other clinical characteristics.

Methods: This prospective observation study included 75 NCWS patients (63 women; median age 36 years) with irritable bowel syndrome (IBS)-like symptoms, 65 IBS and 50 celiac controls. Patients were recruited at two Internal Medicine Departments. Elimination diet and double-blind placebo controlled (DBPC) wheat challenge proved the NCWS diagnosis. All subjects underwent BMD assessment by Dual Energy X-Ray Absorptiometry (DXA), duodenal histology, HLA DQ typing, body mass index (BMI) evaluation and assessment for daily calcium intake.

Results: DBPC cow's milk proteins challenge showed that 30 of the 75 NCWS patients suffered from multiple food sensitivity. Osteopenia and osteoporosis frequency increased from IBS to NCWS and to celiac disease (CD) (P <0.0001). Thirty-five NCWS patients (46.6%) showed osteopenia or osteoporosis. Low BMD was related to low BMI and multiple food sensitivity. Values of daily dietary calcium intake in NCWS patients were significantly lower than in IBS controls.

Conclusions: An elevated frequency of bone mass loss in NCWS patients was found; this was related to low BMI and was more frequent in patients with NCWS associated with other food sensitivity. A low daily intake of dietary calcium was observed in patients with NCWS.

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Related in: MedlinePlus

Percentage of the patients of the three groups who had normal BMD, osteopenia or osteoporosis, evaluated both at the lumbar spine and femoral neck. The frequency of osteopenia and osteoporosis was significantly different in the three groups, increasing from IBS to NCWS, and to CD patients (P <0.0001, Spearman’s rank correlation). BMD, bone mass density; CD, celiac disease; IBS, irritable bowel syndrome; NCWS, non-celiac wheat sensitivity.
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Fig2: Percentage of the patients of the three groups who had normal BMD, osteopenia or osteoporosis, evaluated both at the lumbar spine and femoral neck. The frequency of osteopenia and osteoporosis was significantly different in the three groups, increasing from IBS to NCWS, and to CD patients (P <0.0001, Spearman’s rank correlation). BMD, bone mass density; CD, celiac disease; IBS, irritable bowel syndrome; NCWS, non-celiac wheat sensitivity.

Mentions: Figure 2 shows the percentage of patients of the three groups who had normal BMD, osteopenia or osteoporosis, evaluated both at the femoral neck and at the lumbar spine. The frequency of osteopenia and osteoporosis increased from IBS to NCWS, and to CD patients (P <0.0001, Spearman’s rank correlation). Osteopenia or osteoporosis was found in 28% of the NCWS patients at the femoral neck and in 34% at the lumbar spine, whereas only 6% (lumbar spine) to 8% (femoral neck) of IBS patients had osteopenia and none of them had osteoporosis (for femoral neck P <0.02, chi-square 7.8; for lumbar spine P <0.001, chi-square 13). In total, 35 NCWS patients (46.6%) had osteopenia or osteoporosis at one of the two sites (femoral neck or lumbar spine). CD patients had a higher frequency of osteopenia (50%) and osteoporosis (14%) than both NCWS and IBS patients.Figure 2


Risk of low bone mineral density and low body mass index in patients with non-celiac wheat-sensitivity: a prospective observation study.

Carroccio A, Soresi M, D'Alcamo A, Sciumè C, Iacono G, Geraci G, Brusca I, Seidita A, Adragna F, Carta M, Mansueto P - BMC Med (2014)

Percentage of the patients of the three groups who had normal BMD, osteopenia or osteoporosis, evaluated both at the lumbar spine and femoral neck. The frequency of osteopenia and osteoporosis was significantly different in the three groups, increasing from IBS to NCWS, and to CD patients (P <0.0001, Spearman’s rank correlation). BMD, bone mass density; CD, celiac disease; IBS, irritable bowel syndrome; NCWS, non-celiac wheat sensitivity.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4265355&req=5

Fig2: Percentage of the patients of the three groups who had normal BMD, osteopenia or osteoporosis, evaluated both at the lumbar spine and femoral neck. The frequency of osteopenia and osteoporosis was significantly different in the three groups, increasing from IBS to NCWS, and to CD patients (P <0.0001, Spearman’s rank correlation). BMD, bone mass density; CD, celiac disease; IBS, irritable bowel syndrome; NCWS, non-celiac wheat sensitivity.
Mentions: Figure 2 shows the percentage of patients of the three groups who had normal BMD, osteopenia or osteoporosis, evaluated both at the femoral neck and at the lumbar spine. The frequency of osteopenia and osteoporosis increased from IBS to NCWS, and to CD patients (P <0.0001, Spearman’s rank correlation). Osteopenia or osteoporosis was found in 28% of the NCWS patients at the femoral neck and in 34% at the lumbar spine, whereas only 6% (lumbar spine) to 8% (femoral neck) of IBS patients had osteopenia and none of them had osteoporosis (for femoral neck P <0.02, chi-square 7.8; for lumbar spine P <0.001, chi-square 13). In total, 35 NCWS patients (46.6%) had osteopenia or osteoporosis at one of the two sites (femoral neck or lumbar spine). CD patients had a higher frequency of osteopenia (50%) and osteoporosis (14%) than both NCWS and IBS patients.Figure 2

Bottom Line: Values of daily dietary calcium intake in NCWS patients were significantly lower than in IBS controls.An elevated frequency of bone mass loss in NCWS patients was found; this was related to low BMI and was more frequent in patients with NCWS associated with other food sensitivity.A low daily intake of dietary calcium was observed in patients with NCWS.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Non-celiac gluten sensitivity (NCGS) or 'wheat sensitivity' (NCWS) is included in the spectrum of gluten-related disorders. No data are available on the prevalence of low bone mass density (BMD) in NCWS. Our study aims to evaluate the prevalence of low BMD in NCWS patients and search for correlations with other clinical characteristics.

Methods: This prospective observation study included 75 NCWS patients (63 women; median age 36 years) with irritable bowel syndrome (IBS)-like symptoms, 65 IBS and 50 celiac controls. Patients were recruited at two Internal Medicine Departments. Elimination diet and double-blind placebo controlled (DBPC) wheat challenge proved the NCWS diagnosis. All subjects underwent BMD assessment by Dual Energy X-Ray Absorptiometry (DXA), duodenal histology, HLA DQ typing, body mass index (BMI) evaluation and assessment for daily calcium intake.

Results: DBPC cow's milk proteins challenge showed that 30 of the 75 NCWS patients suffered from multiple food sensitivity. Osteopenia and osteoporosis frequency increased from IBS to NCWS and to celiac disease (CD) (P <0.0001). Thirty-five NCWS patients (46.6%) showed osteopenia or osteoporosis. Low BMD was related to low BMI and multiple food sensitivity. Values of daily dietary calcium intake in NCWS patients were significantly lower than in IBS controls.

Conclusions: An elevated frequency of bone mass loss in NCWS patients was found; this was related to low BMI and was more frequent in patients with NCWS associated with other food sensitivity. A low daily intake of dietary calcium was observed in patients with NCWS.

Show MeSH
Related in: MedlinePlus