Osteoporosis and Celiac Disease: Updates and Hidden Pitfalls

Celiac disease (CD) is an autoimmune disorder caused by gluten ingestion in genetically predisposed individuals. In addition to the typical gastrointestinal symptoms (e.g., diarrhea, bloating, and chronic abdominal pain), CD may also present with a broad spectrum of manifestations, including low bone mineral density (BMD) and osteoporosis. The etiopathology of bone lesions in CD is multifactorial and other conditions, rather than mineral and vitamin D malabsorption, may affect skeletal health, especially those related to the endocrine system. Here, we describe CD-induced osteoporosis in an attempt to enlighten new and less-known aspects, such as the influence of the intestinal microbiome and sex-related differences on bone health. This review describes the role of CD in the development of skeletal alterations to provide physicians with an updated overview on this debated topic and to improve the management of osteoporosis in CD.

Automated summary

Celiac disease (CD) is an autoimmune disorder caused by gluten ingestion in genetically predisposed individuals. Besides gastrointestinal symptoms, CD can also lead to low bone mineral density and osteoporosis. The bone lesions in CD are influenced by various factors, and not only mineral and vitamin D malabsorption. This review aims to provide an updated overview on CD-induced osteoporosis and highlight new aspects such as the impact of the intestinal microbiome and sex-related differences on bone health, in order to improve its management.