{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T03:29:07Z","timestamp":1778902147420,"version":"3.51.4"},"reference-count":26,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2018,12,7]],"date-time":"2018-12-07T00:00:00Z","timestamp":1544140800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003407","name":"Ministero dell\u2019Istruzione, dell\u2019Universit\u00e0 e della Ricerca","doi-asserted-by":"publisher","award":["ORIENTED FINALIZED RESEARCH 2016"],"award-info":[{"award-number":["ORIENTED FINALIZED RESEARCH 2016"]}],"id":[{"id":"10.13039\/501100003407","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Screening strategies to detect celiac disease (CD) in at-risk subjects are of paramount importance to prevent the possible long-term complications of this condition. It is therefore of strategic relevance to understand whether patients diagnosed through screening follow a strict gluten-free diet (GFD), as the non-compliance to this diet can make screening efforts pointless. Currently, no studies have verified whether CD patients diagnosed in their adulthood are adhering to the GFD years after the diagnosis. We retrospectively evaluated the medical records of 750 CD patients diagnosed in our center during January 2004\u2013December 2013 to verify differences between screening detected and clinically diagnosed patients. The groups shared a similar adherence to the GFD (91.2 versus 89.8%, p = 0.857). Moreover, the rates of non-responsive CD, GFD-induced metabolic alterations, and persistence in controls were also similar. Instead, screening-detected patients had a significantly lower rate of osteopenia\/osteoporosis at diagnosis (31.3 versus 46%, p &lt; 0.001). In conclusion, screening strategies for CD in at-risk groups should be encouraged even in the adult population. Patients diagnosed through these strategies had no additional problems compared to those diagnosed for clinical suspicion and might benefit from a protective effect against metabolic bone disease.<\/jats:p>","DOI":"10.3390\/nu10121940","type":"journal-article","created":{"date-parts":[[2018,12,7]],"date-time":"2018-12-07T03:46:14Z","timestamp":1544154374000},"page":"1940","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Celiac Disease Diagnosed through Screening Programs in At-Risk Adults Is Not Associated with Worse Adherence to the Gluten-Free Diet and Might Protect from Osteopenia\/Osteoporosis"],"prefix":"10.3390","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8350-1155","authenticated-orcid":false,"given":"Francesco","family":"Tovoli","sequence":"first","affiliation":[{"name":"Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, 40136 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Negrini","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, 40136 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0913-1934","authenticated-orcid":false,"given":"Vito","family":"Sansone","sequence":"additional","affiliation":[{"name":"Unit of Gastroenterology, Department of Medical and Surgical Sciences, University of Bologna, 40136 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8971-7574","authenticated-orcid":false,"given":"Chiara","family":"Faggiano","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, 40136 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Catenaro","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, 40136 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luigi","family":"Bolondi","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, 40136 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0637-739X","authenticated-orcid":false,"given":"Alessandro","family":"Granito","sequence":"additional","affiliation":[{"name":"Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, 40136 Bologna, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2018,12,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1136\/gutjnl-2011-301346","article-title":"The Oslo definitions for coeliac disease and related terms","volume":"62","author":"Ludvigsson","year":"2013","journal-title":"Gut"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1461","DOI":"10.1111\/j.1572-0241.2007.01167.x","article-title":"Where are all those patients with Celiac disease?","volume":"102","author":"Green","year":"2007","journal-title":"Am. J. Gastroenterol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1097\/MPG.0b013e31821a23d0","article-title":"European Society for Pediatric Gastroenterology, Hepatology, and Nutrition guidelines for the diagnosis of coeliac disease","volume":"54","author":"Husby","year":"2012","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1002\/j.1536-4801.2005.tb00917.x","article-title":"Guideline for the diagnosis and treatment of celiac disease in children: Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition","volume":"40","author":"Hill","year":"2005","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"656","DOI":"10.1038\/ajg.2013.79","article-title":"ACG clinical guidelines: Diagnosis and management of celiac disease","volume":"108","author":"Hill","year":"2013","journal-title":"Am. J. Gastroenterol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1111\/j.1365-2036.2005.02574.x","article-title":"Is coeliac disease screening in risk groups justified? A fourteen-year follow-up with special focus on compliance and quality of life","volume":"22","author":"Viljamaa","year":"2005","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"118","DOI":"10.1016\/j.cgh.2010.10.011","article-title":"Diet improves perception of health and well-being in symptomatic, but not asymptomatic, patients with celiac disease","volume":"9","author":"Ukkola","year":"2011","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1022","DOI":"10.1177\/2050640618778386","article-title":"Long-term health and treatment outcomes in adult coeliac disease patients diagnosed by screening in childhood","volume":"6","author":"Popp","year":"2018","journal-title":"United Eur. Gastroenterol. J."},{"key":"ref_9","first-page":"e582-8","article-title":"Long-term health and quality-of-life consequences of mass screening for childhood celiac disease: A 10-year follow-up study","volume":"123","author":"Schweizer","year":"2009","journal-title":"Pediatrics"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1016\/S0022-3476(00)35904-2","article-title":"Compliance with gluten-free diet in adolescents with screening-detected celiac disease: A 5-year follow-up study","volume":"136","author":"Fabiani","year":"2000","journal-title":"J. Pediatr."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1097\/MPG.0b013e31816f856b","article-title":"Compliance with gluten-free diet in children with coeliac disease","volume":"47","author":"Jadresin","year":"2008","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Laurikka, P., Nurminen, S., Kivel\u00e4, L., and Kurppa, K. (2018). Extraintestinal Manifestations of Celiac Disease: Early Detection for Better Long-Term Outcomes. Nutrients, 10.","DOI":"10.3390\/nu10081015"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.maturitas.2018.03.014","article-title":"Celiac disease and non-celiac gluten or wheat sensitivity and health in later life: A review","volume":"112","author":"Bathrellou","year":"2018","journal-title":"Maturitas"},{"key":"ref_14","unstructured":"(2018, November 07). Italian Guidelines for the Diagnosis and the Follow-up of Celiac Disease. Available online: http:\/\/www.celiachia.it\/public\/bo\/upload\/eventi_progetti\/A.07.Booklet%20Celiachia%20-%20Impaginato.pdf."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1016\/j.jpeds.2016.12.077","article-title":"At-Risk Screened Children with Celiac Disease are Comparable in Disease Severity and Dietary Adherence to Those Found because of Clinical Suspicion: A Large Cohort Study","volume":"183","author":"Kaukinen","year":"2017","journal-title":"J. Pediatr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1097\/MPG.0b013e31825f18ff","article-title":"Burden of illness in screen-detected children with celiac disease and their families","volume":"55","author":"Kinos","year":"2012","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1159\/000341416","article-title":"Factors associated with dietary adherence in celiac disease: A nationwide study","volume":"86","author":"Kurppa","year":"2012","journal-title":"Digestion"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Vilppula, A., Kaukinen, K., Luostarinen, L., Krekel\u00e4, I., Patrikainen, H., Valve, R., Luostarinen, M., Laurila, K., M\u00e4ki, M., and Collin, P. (2011). Clinical benefit of gluten-free diet in screen-detected older celiac disease patients. BMC Gastroenterol., 11.","DOI":"10.1186\/1471-230X-11-136"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/S0140-6736(99)01990-X","article-title":"Osteopenia in patients with clinically silent coeliac disease warrants screening","volume":"354","author":"Mustalahti","year":"1999","journal-title":"Lancet"},{"key":"ref_20","first-page":"273","article-title":"Clinical presentation and incidence of complications in patients with coeliac disease diagnosed by relative screening. Postgrad","volume":"83","author":"Sundar","year":"2007","journal-title":"Med. J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1210\/jc.2014-1858","article-title":"Celiac disease and bone fractures: A systematic review and meta-analysis","volume":"100","author":"Heikkila","year":"2015","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1007\/s00198-004-1822-z","article-title":"Excess non-spine fractures in women over 50 years with celiac disease: A cross-sectional, questionnaire-based study","volume":"16","author":"Davie","year":"2015","journal-title":"Osteoporos. Int."},{"key":"ref_23","first-page":"112","article-title":"Osteoporosis in a north american adult population with celiac disease","volume":"96","author":"Meyer","year":"2001","journal-title":"Am. J. Gastroenterol."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Pantaleoni, S., Luchino, M., Adriani, A., Pellicano, R., Stradella, D., Ribaldone, D.G., Sapone, N., Isaia, G.C., Stefano, M.D., and Astegiano, M. (2014). Bone mineral density at diagnosis of celiac disease and after 1 year of gluten-free diet. Sci. World J., 173082.","DOI":"10.1155\/2014\/173082"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Tolone, C., Bellini, G., Punzo, F., Papparella, A., Miele, E., Vitale, A., Nobili, B., Strisciuglio, C., and Rossi, F. (2017). The DMT1 IVS4+44C>A polymorphism and the risk of iron deficiency anemia in children with celiac disease. PLoS ONE., 12.","DOI":"10.1371\/journal.pone.0185822"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1007\/s00251-005-0033-x","article-title":"The IL-1 gene family and bone involvement in celiac disease","volume":"57","author":"Moreno","year":"2005","journal-title":"Immunogenetics"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/10\/12\/1940\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:31:53Z","timestamp":1760196713000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/10\/12\/1940"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,7]]},"references-count":26,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2018,12]]}},"alternative-id":["nu10121940"],"URL":"https:\/\/doi.org\/10.3390\/nu10121940","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,7]]}}}