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Long-term Fracture Risk in Patients with Celiac Disease: A Population-Based Study in Olmsted County, Minnesota

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Abstract

Celiac disease is associated with decreased bone density, but there are conflicting data regarding fracture risk. We determined the fracture incidence relative to matched controls in a population-based cohort with celiac disease before and after diagnosis. Olmsted County residents with celiac disease (n = 83) diagnosed between 1950 and 2002 were compared with 166 gender and age matched controls. Fracture histories were ascertained from each subject’s medical records. Celiac disease is linked to an increased fracture risk before and after diagnosis. Before the index date, cases had a fracture rate twice that of controls (CI: 1.0–3.9, P = 0.045) and 2.5-fold greater after the index date (CI: 1.1–5.6, P = 0.026). Appendicular and axial fractures were 2.5 (CI: 0.9–6.5) and 3.2 times more likely (CI: 1.0–10.5) after the index date. These observations support a rationale for earlier detection of celiac disease, and active management of bone disease before bone effects have occurred, to reduce the persistent risk of fractures.

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Acknowledgments

The authors would like to thank Kathryn Jensen and Sughra Naqvi for assistance with manuscript preparation. This study was supported in part by research grants DK 57982 and AR 30582 and MO1 RR00585 to the University of Rochester General Clinical Research Center from the National Institutes of Health, US Public Health Service. The funding source had no role in the design or execution of the study.

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Author notes

  1. Mohammed R. Jafri, Joseph A. Murray, Carol T. Van Dyke, Alan R. Zinsmeister & Lee J. Melton III

    Present address: Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

  2. Charles W. Nordstrom

    Present address: , 725 American Way, Waukesha, WI, 53188-5031, USA

Authors and Affiliations

  1. Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA

    Mohammed R. Jafri & Charles W. Nordstrom

  2. Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Ross A. Dierkhising

  3. Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street, SW, Rochester, MN, 55905, USA

    Joseph A. Murray & Carol T. Van Dyke

  4. Divisions of Biostatistics, Mayo Clinic College of Medicine, Rochester, MN, USA

    Ross A. Dierkhising & Alan R. Zinsmeister

  5. Divisions of Epidemiology, Mayo Clinic College of Medicine, Rochester, MN, USA

    Lee J. Melton III

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  1. Mohammed R. Jafri
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Correspondence to Joseph A. Murray.

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Jafri, M.R., Nordstrom, C.W., Murray, J.A. et al. Long-term Fracture Risk in Patients with Celiac Disease: A Population-Based Study in Olmsted County, Minnesota. Dig Dis Sci 53, 964–971 (2008). https://doi.org/10.1007/s10620-007-9976-0

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