Screening for celiac disease in patients with osteoporosis

• Published in: Joint, bone, spine : revue du rhumatisme Vol. 76; no. 2; pp. 162 - 165
• Main Authors: Legroux-Gérot, Isabelle, Leloire, Olivier, Blanckaert, Franck, Tonnel, François, Grardel, Bruno, Ducrocq, Jean-Louis, Cortet, Bernard
• Format: Journal Article
• Language: English
• Published: France Elsevier SAS 01.03.2009
• Subjects: Adult; Aged; Antibodies, Anti-Idiotypic - blood; Biomarkers - blood; Celiac disease; Celiac Disease - blood; Celiac Disease - complications; Celiac Disease - epidemiology; Cohort Studies; Comorbidity; Female; Fracture; France - epidemiology; Gliadin - immunology; Humans; Immunoglobulin A - immunology; Internal Medicine; Male; Mass Screening; Middle Aged; Osteoporosis; Osteoporosis - blood; Osteoporosis - complications; Osteoporosis - epidemiology; Rheumatology; France; Osteoporosis; Celiac disease; Fracture
• ISSN: 1297-319X; 1778-7254
• DOI: 10.1016/j.jbspin.2008.06.016

Abstract Objective Whether patients with osteoporosis should be screened for celiac disease is controversial. The objective of this study was to measure the prevalence of asymptomatic celiac disease in a cohort of patients with osteoporosis. Methods We studied 140 patients (133 postmenopausal women and 7 men) aged 40–75 years (mean age, 62.9 ± 9.4 years) with primary osteoporosis diagnosed by absorptiometry (spine or hip T -score <−2.5 SD). We routinely measured serum and urinary calcium, serum phosphate, alkaline phosphatase, 25-OH-vitamin D3, and IgG and IgA antigliadin antibodies. Patients with positive antigliadin antibody tests were tested for antitransglutaminase antibodies. Results A history of fractures were noted in 52 (37%) patients, with 57 peripheral and 54 vertebral fractures overall. Vitamin D deficiency was found in 60 (43%) patients. IgG antigliadin antibodies were positive in 11 (8%) patients, IgA antigliadin antibodies in 11 (8%) patients, and both antibodies in 4 (3%) patients. Antitransglutaminase antibodies were negative in all patients. No significant differences in laboratory test or absorptiometry results were found between patients with versus without IgA antigliadin antibodies. The T -score at the spine was nonsignificantly lower in patients with than without IgG antigliadin antibodies (−3.17 ± 0.49 and −2.82 ± 0.77, P = 0.076). Conclusion We found no excess risk of celiac disease in our cohort of patients with osteoporosis. Despite the small sample size, our results cast doubt on the need for celiac-disease screening in osteoporotic patients who have no gastrointestinal symptoms.