{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T23:13:20Z","timestamp":1785798800229,"version":"3.56.0"},"reference-count":44,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,3,27]],"date-time":"2020-03-27T00:00:00Z","timestamp":1585267200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"FC (Fondazione Celiachia Onlus)","award":["008 FC 2015"],"award-info":[{"award-number":["008 FC 2015"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: Adults with celiac disease (CeD) show low bone mineral density (BMD) and high fracture risk. CeD guidelines suggest measurements of serum minerals and vitamin D. However, studies on vitamin levels in CeD patients are contradictory. Aim: To investigate in CeD, 25-hydroxy-vitamin D [25(OH)D], 1,25-dihydroxy-vitamin D [1,25(OH)2D], and related analytes and to evaluate their relationships to peripheral BMD as assessed by peripheral quantitative computed tomography (pQCT). Methods: Gluten-free diet (GFD)-treated, and untreated adult CeD patients na\u00efve to vitamin D and calcium supplementation underwent measurements of serum 25(OH)D, 1,25(OH)2D, parathyroid hormone (PTH), total calcium, phosphate, and of radius BMD by pQCT. Results: Complete data were collected in 105 patients for lab tests and 87 patients for BMD. For lab tests, untreated CeD differed from treated CeD for 22.0% lower serum 25(OH)D (p = 0.023), 42.5% higher serum PTH (p &lt; 0.001), and 13.0% higher serum 1,25(OH)2D (p = 0.029) in the presence of similar serum calcium and phosphorus (p &gt; 0.35). For BMD, untreated CeD differed from treated CeD for lower diaphyseal cortical BMD (1133 and 1157 mg\/cm3, p = 0.004) but not for distal BMD (total, trabecular, and subcortical, p &gt; 0.13). Independent correlates of diaphyseal cortical BMD were GFD treatment and body mass index (p &lt; 0.05). Conclusions: Data indicated that, compared to CeD patients on a gluten-free diet, untreated adult CeD patients at diagnosis had lower 25(OH)D, higher PTH, and higher 1,25(OH)2D in the absence of difference in serum calcium and phosphorus. 25(OH)D and 1,25(OH)2D, even below the normal range, were not associated with BMD. Our findings do not support the use of vitamin D supplementation for all CeD adults.<\/jats:p>","DOI":"10.3390\/nu12040929","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T10:29:38Z","timestamp":1585650578000},"page":"929","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["25-Hydroxyvitamin D, 1,25-Dihydroxyvitamin D, and Peripheral Bone Densitometry in Adults with Celiac Disease"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7426-1145","authenticated-orcid":false,"given":"Carolina","family":"Ciacci","sequence":"first","affiliation":[{"name":"Celiac Center at Department of Medicine, Surgery, Dentistry, Scuola Medica Salernitana, University of Salerno, 84126 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0845-1194","authenticated-orcid":false,"given":"Giancarlo","family":"Bilancio","sequence":"additional","affiliation":[{"name":"Nephrology Unit, AOU San Giovanni di Dio e Ruggi d\u2019Aragona, 84126 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Russo","sequence":"additional","affiliation":[{"name":"Celiac Center at Department of Medicine, Surgery, Dentistry, Scuola Medica Salernitana, University of Salerno, 84126 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9568-0680","authenticated-orcid":false,"given":"Paola","family":"Iovino","sequence":"additional","affiliation":[{"name":"Celiac Center at Department of Medicine, Surgery, Dentistry, Scuola Medica Salernitana, University of Salerno, 84126 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3111-5241","authenticated-orcid":false,"given":"Pierpaolo","family":"Cavallo","sequence":"additional","affiliation":[{"name":"Department of Physics, University of Salerno, 84126 Salerno, Italy"},{"name":"ISC-CNR, Istituto Sistemi Complessi del CNR, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9094-765X","authenticated-orcid":false,"given":"Antonella","family":"Santonicola","sequence":"additional","affiliation":[{"name":"Celiac Center at Department of Medicine, Surgery, Dentistry, Scuola Medica Salernitana, University of Salerno, 84126 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Bucci","sequence":"additional","affiliation":[{"name":"Celiac Center at Department of Medicine, Surgery, Dentistry, Scuola Medica Salernitana, University of Salerno, 84126 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6409-3504","authenticated-orcid":false,"given":"Massimo","family":"Cirillo","sequence":"additional","affiliation":[{"name":"Department of Public Health, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1133-1502","authenticated-orcid":false,"given":"Fabiana","family":"Zingone","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, Department of Surgery, Oncology and Gastroenterology, University of Padua, 35128 Padua, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,3,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/j.jpeds.2018.02.070","article-title":"Risk of Fractures in Youths with Celiac Disease-A Population-Based Study","volume":"198","author":"Canova","year":"2018","journal-title":"J. Pediatr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1007\/s00198-016-3791-4","article-title":"Celiac disease is associated with reduced bone mineral density and increased FRAX scores in the US National Health and Nutrition Examination Survey","volume":"28","author":"Kamycheva","year":"2017","journal-title":"Osteoporos. Int."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1136\/gutjnl-2013-306578","article-title":"Diagnosis and management of adult coeliac disease: Guidelines from the British Society of Gastroenterology","volume":"63","author":"Ludvigsson","year":"2014","journal-title":"Gut"},{"key":"ref_4","first-page":"757","article-title":"The value and significance of 25(OH) and 1,25(OH) vitamin D serum levels in adult coeliac patients: A review of the literature","volume":"50","author":"Zingone","year":"2018","journal-title":"Dig. Liver Dis. Off. J. Ital. Soc. Gastroenterol. Ital. Assoc. Study Liver"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"449","DOI":"10.1097\/MPG.0000000000002417","article-title":"Should We Assess Vitamin D Status in Pediatric Patients with Celiac Disease?","volume":"69","author":"Ahlawat","year":"2019","journal-title":"J. Pediatr. Gastroenterol. Nutr."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1016\/j.mayocp.2018.11.036","article-title":"Micronutrient Deficiencies Are Common in Contemporary Celiac Disease Despite Lack of Overt Malabsorption Symptoms","volume":"94","author":"Bledsoe","year":"2019","journal-title":"Mayo Clin. Proc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1007\/s12016-010-8237-8","article-title":"The clinical significance of 25OH-Vitamin D status in celiac disease","volume":"42","author":"Lerner","year":"2012","journal-title":"Clin. Rev. Allergy Immunol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1186\/s12887-018-1107-x","article-title":"Fat soluble vitamin levels in children with newly diagnosed celiac disease, a case control study","volume":"18","author":"Terlemez","year":"2018","journal-title":"BMC Pediatr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"5082","DOI":"10.3168\/jds.2010-3359","article-title":"Vitamin D content and variability in fluid milks from a US Department of Agriculture nationwide sampling to update values in the National Nutrient Database for Standard Reference","volume":"93","author":"Patterson","year":"2010","journal-title":"J. Dairy Sci."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.jsbmb.2017.11.014","article-title":"Why should we measure free 25(OH) vitamin D?","volume":"180","author":"Tsuprykov","year":"2018","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1007\/s00418-018-1648-y","article-title":"Functions of vitamin D in bone","volume":"149","author":"Goltzman","year":"2018","journal-title":"Histochem. Cell Biol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/0016-5085(95)90276-7","article-title":"Bone mass and metabolism in patients with celiac disease","volume":"109","author":"Corazza","year":"1995","journal-title":"Gastroenterology"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Cirillo, M., Bilancio, G., Guarino, E., Cavallo, P., Lombardi, C., Costanzo, S., De Curtis, A., Di Castelnuovo, A., and Iacoviello, L. (2019). Vitamin D Status and Indices of Mineral Homeostasis in the Population: Differences Between 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D. Nutrients, 11.","DOI":"10.3390\/nu11081777"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.2337\/dc18-2376","article-title":"Abnormal Cortical and Trabecular Bone in Youth with Type 1 Diabetes and Celiac Disease","volume":"42","author":"Donaghue","year":"2019","journal-title":"Diabetes Care"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1016\/j.ejrad.2009.04.074","article-title":"Quantitative computed tomography","volume":"71","author":"Adams","year":"2009","journal-title":"Eur. J. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1016\/j.jocd.2007.12.010","article-title":"Clinical use of quantitative computed tomography and peripheral quantitative computed tomography in the management of osteoporosis in adults: The 2007 ISCD Official Positions","volume":"11","author":"Engelke","year":"2008","journal-title":"J. Clin. Densitom."},{"key":"ref_17","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_18","doi-asserted-by":"crossref","first-page":"2020","DOI":"10.1001\/jama.2018.14854","article-title":"The Physical Activity Guidelines for Americans","volume":"320","author":"Piercy","year":"2018","journal-title":"JAMA"},{"key":"ref_19","unstructured":"(2020, March 26). Atlante Italiano Della Radiazione Solare (English Translation: Italian Atlas of Solar Irradiation). Available online: www.solaritaly.enea.it."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann. Intern. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/j.jsbmb.2015.08.005","article-title":"A novel, fully-automated, chemiluminescent assay for the detection of 1,25-dihydroxyvitamin D in biological samples","volume":"164","author":"Valcour","year":"2016","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1017\/S000711451000214X","article-title":"UK Food Standards Agency Workshop Consensus Report: The choice of method for measuring 25-hydroxyvitamin D to estimate vitamin D status for the UK National Diet and Nutrition Survey","volume":"104","author":"Wallace","year":"2010","journal-title":"Br. J. Nutr."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"4907","DOI":"10.1021\/acs.analchem.6b05168","article-title":"Development of an Improved Standard Reference Material for Vitamin D Metabolites in Human Serum","volume":"89","author":"Phinney","year":"2017","journal-title":"Anal. Chem."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1065","DOI":"10.1097\/00005768-200207000-00002","article-title":"Body mass index and mortality: The influence of physical activity and smoking","volume":"34","author":"Meyer","year":"2002","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1038\/sj.ijo.0802870","article-title":"The effects of physical activity and body mass index on cardiovascular, cancer and all-cause mortality among 47 212 middle-aged Finnish men and women","volume":"29","author":"Hu","year":"2005","journal-title":"Int. J. Obes."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2137","DOI":"10.1016\/j.ejca.2012.02.063","article-title":"Excess body weight and the risk of primary liver cancer: An updated meta-analysis of prospective studies","volume":"48","author":"Chen","year":"2012","journal-title":"Eur. J. Cancer"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/BF01623237","article-title":"Forearm BMD as measured by peripheral quantitative computed tomography (pQCT) in a German reference population","volume":"4","author":"Butz","year":"1994","journal-title":"Osteoporos. Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.jocd.2007.06.001","article-title":"DXA-generated Z-scores and T-scores may differ substantially and significantly in young adults","volume":"10","author":"Carey","year":"2007","journal-title":"J. Clin. Densitom."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1359\/jbmr.1999.14.4.652","article-title":"Bone loss in celiac disease is related to secondary hyperparathyroidism","volume":"14","author":"Selby","year":"1999","journal-title":"J. Bone Miner. Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1080\/10408398.2012.688897","article-title":"Vitamin D bioavailability: State of the art","volume":"55","author":"Borel","year":"2015","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e44","DOI":"10.1097\/PAS.0000000000001107","article-title":"Statement on Best Practices in the Use of Pathology as a Diagnostic Tool for Celiac Disease: A Guide for Clinicians and Pathologists","volume":"42","author":"Robert","year":"2018","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_32","first-page":"1480","article-title":"Hypocalciuria in overt and subclinical celiac disease","volume":"90","author":"Ciacci","year":"1995","journal-title":"Am. J. Gastroenterol."},{"key":"ref_33","first-page":"280","article-title":"Pathologic fractures, anemia, hypercalcemia and hypocalciuria: An association between celiac disease and hyperparathyroidism","volume":"1","author":"Kariv","year":"1999","journal-title":"ISR Med. Assoc. J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/S8756-3282(98)00178-1","article-title":"Osteoporosis in adult patients with celiac disease","volume":"24","author":"Kemppainen","year":"1999","journal-title":"Bone"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"3975","DOI":"10.3390\/nu5103975","article-title":"Vitamin and mineral deficiencies are highly prevalent in newly diagnosed celiac disease patients","volume":"5","author":"Wierdsma","year":"2013","journal-title":"Nutrients"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"e221","DOI":"10.1097\/MCG.0000000000001032","article-title":"Alterations of Inflammatory and Matrix Production Indices in Celiac Disease with Low Bone Mass on Long-term Gluten-free Diet","volume":"53","author":"Bergonzi","year":"2019","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_37","first-page":"992","article-title":"Effects of dietary treatment on bone mineral density in adults with celiac disease: Factors predicting response","volume":"92","author":"Ciacci","year":"1997","journal-title":"Am. J. Gastroenterol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1038\/ejcn.2016.178","article-title":"Comparison of high-resolution peripheral quantitative computerized tomography with dual-energy X-ray absorptiometry for measuring bone mineral density","volume":"71","author":"Colt","year":"2017","journal-title":"Eur. J. Clin. Nutr."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1020","DOI":"10.1359\/jbmr.2003.18.6.1020","article-title":"Patient-specific DXA bone mineral density inaccuracies: Quantitative effects of nonuniform extraosseous fat distributions","volume":"18","author":"Bolotin","year":"2003","journal-title":"J. Bone Miner. Res."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1016\/j.bone.2015.03.005","article-title":"Significant bone microarchitecture impairment in premenopausal women with active celiac disease","volume":"76","author":"Zanchetta","year":"2015","journal-title":"Bone"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.beem.2011.06.007","article-title":"Worldwide vitamin D status","volume":"25","author":"Lips","year":"2011","journal-title":"Best Pract. Res. Clin. Endocrinol. Metab."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Zhou, P., Hu, J., Xi, P., Zhang, N., Yang, B., Zheng, J., and Wang, X. (2017). Survey on the levels of 25-hydroxy vitamin D and bone metabolic markers and evaluation of their correlations with osteoporosis in perimenopausal woman in Xi\u2019an region. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0180366"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"2619","DOI":"10.1007\/s00198-017-4100-6","article-title":"Determinants of bone mineral density in young Australian women; results from the Safe-D study","volume":"28","author":"Callegari","year":"2017","journal-title":"Osteoporos. Int."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"818","DOI":"10.7326\/M15-1361","article-title":"Treatment of Low Bone Density or Osteoporosis to Prevent Fractures in Men and Women: A Clinical Practice Guideline Update From the American College of Physicians","volume":"166","author":"Qaseem","year":"2017","journal-title":"Ann. Intern. Med."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/4\/929\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:12:21Z","timestamp":1760173941000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/4\/929"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,27]]},"references-count":44,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,4]]}},"alternative-id":["nu12040929"],"URL":"https:\/\/doi.org\/10.3390\/nu12040929","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,27]]}}}