Celiac disease (CD) is a gluten sensitive enteropathy with intestinal and extra intestinal presentations in genetically predisposed cases. Musculoskeletal problems are one of the most common extra intestinal manifestations in adult Celiac disease. In present study we evaluated prevalence of bone loss in celiac patients in men and premenopausal women . Aim of study was risk stratification of bone loss base on age and decade of life to find out best age for screening patients for bone loss .

This was a cross-sectional study of 526 adult CD patients with positive serology and pathology who were referred to the Mashhad Celiac Clinic Center between 2010 and 2020. We excluded the bone loss confounding factors including cases with endocrine disorders, corticosteroid consumption, smoking, and post menopausal women and men more than 50 years old.413 patients were included. Factors such as intestinal pathology, bone mineral density (BMD), serum level of anti-tTG, serum vitamin D, and hemoglobin levels were also assessed at the time of diagnosis.

: BMD was evaluated in patients. Femoral osteopenia was found in 35%, 34%, 36% % of patients in second, third and forth decade of life ,and osteoporosis was seen in 11%, 7%, 19% had in femoral. Spinal osteopenia was see in 39%,22%,42% and osteoporosis in 10%,4.5%,16% were observed . There was no significant difference between femoral osteopenia and osteoporosis in three cade of life .Spinal osteoporosis was more common from forth decade .

This study showed low bone mineral density is common even in second and thirddecade of life and we recommend to screen for bon loss from thirty years old.