{
  "abstract": "Introduction Individuals with coeliac disease (CD) are at higher risk of metabolic bone disease (MBD) including osteopenia and osteoporosis, therefore it is recommended that baseline dual energy X-ray absorptiometry (DEXA) is performed for all newly diagnosed patients, irrespective of micronutrient deficiency or age. However, it is unknown whether using the criteria of age or concomitant micronutrient deficiency can stratify the risk of MBD in patients newly diagnosed with coeliac disease to reduce unnecessary DEXA scans. We aimed to identify whether younger patients with CD were at significantly lower risk of MBD, or whether micronutrient deficiency (folate, B12, vitamin D, iron) was significantly correlated with DEXA results.Methods We performed a retrospective cohort study of adult patients newly diagnosed with CD in a single regional specialist clinic. All adult patients with histologically or serologically diagnosed CD between 2020 and 2025 who had a DEXA within two years of diagnosis were included. Electronic healthcare records were reviewed to record patient characteristics, coeliac serology titres, histopathology results, and micronutrient serum levels. Radiology assessment of MBD via DEXA scan was collected.Results Over five years, 352 patients were newly diagnosed with CD and had a DEXA scan performed within two years of diagnosis (median age 44, 70.6% female). MBD was diagnosed in 148 patients (43.1%), 126 with osteopenia (36.7%) and 22 with osteoporosis (6.4%). The prevalence of any micronutrient deficiency was 64.9%, with iron deficiency most common (148 patients, 43%), followed by folate (38 patients, 11%) and B12 deficiency least common (23 patients, 6.7%).There was no significant difference in the prevalence of MBD between individuals with and without vitamin D deficiency (χ2=0.21, p=0.65) or haematinic deficiency (χ2=0.03, p=0.872). In patients with normal vitamin D, 43.2% had MBD, as did 38.1% of patients with normal vitamin D under 30 years of age. While older age was significantly associated with MBD (Z=-4.87, p=0.00001), the proportion of those under 30 and under 40 with MBD was 29.2% and 34.8% respectively.Conclusion Metabolic bone disease prevalence in CD is independent of the degree of micronutrient or vitamin D deficiency at diagnosis, including in younger age groups. Metabolic bone disease is common in patients with newly diagnosed CD, even in younger age groups. We conclude that DEXA has utility in the workup of new cases of CD despite normal micronutrients and younger age.",
  "authors": [
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Oxford, United Kingdom",
        "Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom"
      ],
      "name": "James Everson"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Oxford, United Kingdom",
        "Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom"
      ],
      "name": "Darrien Henry"
    },
    {
      "affiliations": [
        "Oxford University, Oxford, United Kingdom"
      ],
      "name": "Nadia Ford"
    },
    {
      "affiliations": [
        "Oxford University, Oxford, United Kingdom"
      ],
      "name": "Cameron Doyle"
    },
    {
      "affiliations": [
        "Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom"
      ],
      "name": "Eleanor Coleby"
    },
    {
      "affiliations": [
        "Department of Gastroenterology and Hepatology, Oxford, United Kingdom",
        "Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom"
      ],
      "name": "Michael FitzPatrick"
    }
  ],
  "title": "P377 Prevalence of metabolic bone disease and micronutrient deficiency in newly-diagnosed coeliac disease: a retrospective cohort study",
  "uid": "056f0b31-ce98-59c8-a2bc-4f730377d0e6"
}