Skip to main content
Top
Published in: BMC Medicine 1/2014

Open Access 01-12-2014 | Research article

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

Authors: Antonio Carroccio, Maurizio Soresi, Alberto D’Alcamo, Carmelo Sciumè, Giuseppe Iacono, Girolamo Geraci, Ignazio Brusca, Aurelio Seidita, Floriana Adragna, Miriam Carta, Pasquale Mansueto

Published in: BMC Medicine | Issue 1/2014

Login to get access

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.
Appendix
Available only for authorised users
Literature
1.
go back to reference Corazza GR, Di Sario A, Cecchetti L, Tarozzi C, Corrao G, Bernardi M, Gasbarrini G: Bone mass and metabolism in patients with coeliac disease. Gastroenterology. 1995, 109: 122-128. 10.1016/0016-5085(95)90276-7.CrossRefPubMed Corazza GR, Di Sario A, Cecchetti L, Tarozzi C, Corrao G, Bernardi M, Gasbarrini G: Bone mass and metabolism in patients with coeliac disease. Gastroenterology. 1995, 109: 122-128. 10.1016/0016-5085(95)90276-7.CrossRefPubMed
2.
go back to reference Sapone A, Bai JC, Ciacci C, Dolinsek J, Green PH, Hadjivassiliou M, Kaukinen K, Rostami K, Sanders DS, Schumann M, Ullrich R, Villalta D, Volta U, Catassi C, Fasano A: Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Med. 2012, 10: 13-10.1186/1741-7015-10-13.CrossRefPubMedPubMedCentral Sapone A, Bai JC, Ciacci C, Dolinsek J, Green PH, Hadjivassiliou M, Kaukinen K, Rostami K, Sanders DS, Schumann M, Ullrich R, Villalta D, Volta U, Catassi C, Fasano A: Spectrum of gluten-related disorders: consensus on new nomenclature and classification. BMC Med. 2012, 10: 13-10.1186/1741-7015-10-13.CrossRefPubMedPubMedCentral
3.
go back to reference Catassi C, Bai JC, Bonaz B, Bouma G, Calabrò A, Carroccio A, Castillejo G, Ciacci C, Cristofori F, Dolinsek J, Francavilla R, Elli L, Green P, Holtmeier W, Koehler P, Koletzko S, Meinhold C, Sanders D, Schumann M, Schuppan D, Ullrich R, Vécsei A, Volta U, Zevallos V, Sapone A: Fasano: non-celiac gluten sensitivity: the new frontier of gluten related disorders. Nutrients. 2013, 5: 3839-3853. 10.3390/nu5103839.CrossRefPubMedPubMedCentral Catassi C, Bai JC, Bonaz B, Bouma G, Calabrò A, Carroccio A, Castillejo G, Ciacci C, Cristofori F, Dolinsek J, Francavilla R, Elli L, Green P, Holtmeier W, Koehler P, Koletzko S, Meinhold C, Sanders D, Schumann M, Schuppan D, Ullrich R, Vécsei A, Volta U, Zevallos V, Sapone A: Fasano: non-celiac gluten sensitivity: the new frontier of gluten related disorders. Nutrients. 2013, 5: 3839-3853. 10.3390/nu5103839.CrossRefPubMedPubMedCentral
4.
go back to reference Carroccio A, Mansueto P, Iacono G, Soresi M, D'Alcamo A, Cavataio F, Brusca I, Florena AM, Ambrosiano G, Seidita A, Pirrone G, Rini GB: Non-celiac wheat sensitivity diagnosed by double-blind placebo controlled challenge: exploring a new clinical entity. Am J Gastroenterol. 2012, 107: 1898-1906. 10.1038/ajg.2012.236.CrossRefPubMed Carroccio A, Mansueto P, Iacono G, Soresi M, D'Alcamo A, Cavataio F, Brusca I, Florena AM, Ambrosiano G, Seidita A, Pirrone G, Rini GB: Non-celiac wheat sensitivity diagnosed by double-blind placebo controlled challenge: exploring a new clinical entity. Am J Gastroenterol. 2012, 107: 1898-1906. 10.1038/ajg.2012.236.CrossRefPubMed
5.
go back to reference Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Müller-Lissner SA: Functional bowel disorders and functional abdominal pain. Gut. 1999, 45: 43-47. Thompson WG, Longstreth GF, Drossman DA, Heaton KW, Irvine EJ, Müller-Lissner SA: Functional bowel disorders and functional abdominal pain. Gut. 1999, 45: 43-47.
6.
go back to reference Rostami K, Kerckhaert J, Tiemessen R, von Blomberg BM, Meijer JW, Mulder CJ: Sensitivity of antiendomysium and antigliadin antibodies in untreated celiac disease: disappointing in clinical practice. Am J Gastroenterol. 1999, 94: 888-894. 10.1111/j.1572-0241.1999.983_f.x.CrossRefPubMed Rostami K, Kerckhaert J, Tiemessen R, von Blomberg BM, Meijer JW, Mulder CJ: Sensitivity of antiendomysium and antigliadin antibodies in untreated celiac disease: disappointing in clinical practice. Am J Gastroenterol. 1999, 94: 888-894. 10.1111/j.1572-0241.1999.983_f.x.CrossRefPubMed
7.
go back to reference Carroccio A, Montalto G, Cavera G, Notarbatolo A: Lactose intolerance and self-reported milk intolerance: relationship with lactose maldigestion and nutrient intake. J Am Coll Nutr. 1998, 17: 631-636. 10.1080/07315724.1998.10718813.CrossRefPubMed Carroccio A, Montalto G, Cavera G, Notarbatolo A: Lactose intolerance and self-reported milk intolerance: relationship with lactose maldigestion and nutrient intake. J Am Coll Nutr. 1998, 17: 631-636. 10.1080/07315724.1998.10718813.CrossRefPubMed
8.
go back to reference Istituto Nazionale della Nutrizione (Italian Institute for Nutrition): Food Composition Tables. Rome: ᅟ; 1986. Istituto Nazionale della Nutrizione (Italian Institute for Nutrition): Food Composition Tables. Rome: ᅟ; 1986.
9.
go back to reference Mooney PD, Aziz I, Sanders DS: Non-celiac gluten sensitivity: clinical relevance and recommendations for future research. Neurogastroenterol Motil. 2013, 25: 864-871. 10.1111/nmo.12216.CrossRefPubMed Mooney PD, Aziz I, Sanders DS: Non-celiac gluten sensitivity: clinical relevance and recommendations for future research. Neurogastroenterol Motil. 2013, 25: 864-871. 10.1111/nmo.12216.CrossRefPubMed
10.
go back to reference Biesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR: No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology. 2013, 145: 320-328. 10.1053/j.gastro.2013.04.051.CrossRefPubMed Biesiekierski JR, Peters SL, Newnham ED, Rosella O, Muir JG, Gibson PR: No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates. Gastroenterology. 2013, 145: 320-328. 10.1053/j.gastro.2013.04.051.CrossRefPubMed
11.
go back to reference Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG: A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014, 146: 67-75. 10.1053/j.gastro.2013.09.046.CrossRefPubMed Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG: A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014, 146: 67-75. 10.1053/j.gastro.2013.09.046.CrossRefPubMed
12.
go back to reference Junker Y, Zeissig S, Kim SJ, Barisani D, Wieser H, Leffler DA, Zevallos V, Libermann TA, Dillon S, Freitag TL, Kelly CP, Schuppan D: Wheat amylase trypsin inhibitors drive intestinal inflammation via activation of toll-like receptor 4. J Exp Med. 2012, 209: 2395-2408. 10.1084/jem.20102660.CrossRefPubMedPubMedCentral Junker Y, Zeissig S, Kim SJ, Barisani D, Wieser H, Leffler DA, Zevallos V, Libermann TA, Dillon S, Freitag TL, Kelly CP, Schuppan D: Wheat amylase trypsin inhibitors drive intestinal inflammation via activation of toll-like receptor 4. J Exp Med. 2012, 209: 2395-2408. 10.1084/jem.20102660.CrossRefPubMedPubMedCentral
13.
go back to reference Carroccio A, Mansueto P, D'Alcamo A, Iacono G: Non-celiac wheat sensitivity as an allergic condition: personal experience and narrative review. Am J Gastroenterol. 2013, 108: 1845-1852. 10.1038/ajg.2013.353.CrossRefPubMed Carroccio A, Mansueto P, D'Alcamo A, Iacono G: Non-celiac wheat sensitivity as an allergic condition: personal experience and narrative review. Am J Gastroenterol. 2013, 108: 1845-1852. 10.1038/ajg.2013.353.CrossRefPubMed
14.
go back to reference Carroccio A, Rini G, Mansueto P: Non-celiac wheat sensitivity is a more appropriate label than non-celiac gluten sensitivity. Gastroenterology. 2014, 146: 320-321. 10.1053/j.gastro.2013.08.061.CrossRefPubMed Carroccio A, Rini G, Mansueto P: Non-celiac wheat sensitivity is a more appropriate label than non-celiac gluten sensitivity. Gastroenterology. 2014, 146: 320-321. 10.1053/j.gastro.2013.08.061.CrossRefPubMed
15.
go back to reference Aziz I, Lewis NR, Hadjivassiliou M, Winfield SN, Rugg N, Kelsall A, Newrick L, Sanders DS: A UK study assessing the population prevalence of self-reported gluten sensitivity and referral characteristics to secondary care. Eur J Gastroenterol Hepatol. 2014, 26: 33-39. 10.1097/01.meg.0000435546.87251.f7.CrossRefPubMed Aziz I, Lewis NR, Hadjivassiliou M, Winfield SN, Rugg N, Kelsall A, Newrick L, Sanders DS: A UK study assessing the population prevalence of self-reported gluten sensitivity and referral characteristics to secondary care. Eur J Gastroenterol Hepatol. 2014, 26: 33-39. 10.1097/01.meg.0000435546.87251.f7.CrossRefPubMed
16.
go back to reference DiGiacomo DV, Tennyson CA, Green PH, Demmer RT: Prevalence of gluten-free diet adherence among individuals without celiac disease in the USA: results from the Continuous National Health and Nutrition Examination Survey 2009–2010. Scand J Gastroenterol. 2013, 48: 921-925. 10.3109/00365521.2013.809598.CrossRefPubMed DiGiacomo DV, Tennyson CA, Green PH, Demmer RT: Prevalence of gluten-free diet adherence among individuals without celiac disease in the USA: results from the Continuous National Health and Nutrition Examination Survey 2009–2010. Scand J Gastroenterol. 2013, 48: 921-925. 10.3109/00365521.2013.809598.CrossRefPubMed
17.
go back to reference Ciacci C, Bucci C, Zingone F, Fortunato A, Napoli M, Morra A, Iovino P: What non celiac gluten sensitive patients do not eat (beside gluten). 2013, 15th International Celiac Disease Symposium, Chicago Ciacci C, Bucci C, Zingone F, Fortunato A, Napoli M, Morra A, Iovino P: What non celiac gluten sensitive patients do not eat (beside gluten). 2013, 15th International Celiac Disease Symposium, Chicago
18.
go back to reference Tavakkoli A, Lewis SK, Tennyson CA, Lebwohl B, Green PH: Characteristics of patients who avoid wheat and/or gluten in the absence of Celiac disease. Dig Dis Sci. 2014, 59: 1255-1261. 10.1007/s10620-013-2981-6.CrossRefPubMed Tavakkoli A, Lewis SK, Tennyson CA, Lebwohl B, Green PH: Characteristics of patients who avoid wheat and/or gluten in the absence of Celiac disease. Dig Dis Sci. 2014, 59: 1255-1261. 10.1007/s10620-013-2981-6.CrossRefPubMed
19.
go back to reference Volta U, Bardella MT, Calabrò A, Troncone R, Corazza GR: An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med. 2014, 12: 85-10.1186/1741-7015-12-85.CrossRefPubMedPubMedCentral Volta U, Bardella MT, Calabrò A, Troncone R, Corazza GR: An Italian prospective multicenter survey on patients suspected of having non-celiac gluten sensitivity. BMC Med. 2014, 12: 85-10.1186/1741-7015-12-85.CrossRefPubMedPubMedCentral
Metadata
Title
Risk of low bone mineral density and low body mass index in patients with non-celiac wheat-sensitivity: a prospective observation study
Authors
Antonio Carroccio
Maurizio Soresi
Alberto D’Alcamo
Carmelo Sciumè
Giuseppe Iacono
Girolamo Geraci
Ignazio Brusca
Aurelio Seidita
Floriana Adragna
Miriam Carta
Pasquale Mansueto
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2014
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-014-0230-2

Other articles of this Issue 1/2014

BMC Medicine 1/2014 Go to the issue