Screening for asymptomatic celiac disease among patients referred for bone densitometry measurement

Bone. 2003 Dec;33(6):970-4. doi: 10.1016/j.bone.2003.07.002.

Abstract

Celiac disease (CD) is a relatively common gastrointestinal disorder that can be asymptomatic. An increased prevalence of subclinical CD has been reported in many populations. Even among asymptomatic patients a reduction in bone mineral density (BMD) has been observed. The aim of this study was to evaluate the prevalence of silent CD in a cohort of consecutive individuals referred for bone densitometry measurement. Serum samples were taken from 454 women attending for bone densitometry (mean age: 56 +/- 11 years). Of the individuals evaluated, 89 had normal BMD and 365 had low BMD (T score < -1.0). Subjects were screened for the presence of serum IgA anti-endomysial antibodies (EMA) and IgA tissue transglutaminase (tTG) antibodies by indirect immunofluorescence and enzyme-linked immunosorbent assay (ELISA), respectively. BMD was measured by dual X-ray absorptiometry (DEXA) at the lumbar spine and femoral neck. Eight EMA tTG-positive individuals were identified in this population (1.8% or 1:57). Serologically positive women had a lower mean Z score at both the lumbar spine and femoral neck than EMA tTG-negative women. But this did not approach significance. There was no significant difference in the incidence of CD between the normal- and low-BMD groups in this dataset (P = 0.365). In conclusion, our study indicates that the prevalence of CD in our dataset is high. However, the frequency of asymptomatic CD among low-BMD individuals is similar to that among normal-BMD individuals in our population. These observations do not support the hypothesis that serological testing for CD may be a good accompaniment to DEXA scanning.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adult
  • Aged
  • Aged, 80 and over
  • Autoantibodies / blood
  • Autoantibodies / immunology
  • Bone Density*
  • Bone Diseases, Metabolic / diagnosis
  • Bone Diseases, Metabolic / immunology
  • Celiac Disease / diagnosis
  • Celiac Disease / epidemiology*
  • Data Interpretation, Statistical
  • Esophagus / immunology
  • Female
  • GTP-Binding Proteins / immunology
  • Humans
  • Immunoglobulin A / blood
  • Immunoglobulin A / immunology
  • Ireland / epidemiology
  • Lumbar Vertebrae / chemistry
  • Mass Screening
  • Middle Aged
  • Protein Glutamine gamma Glutamyltransferase 2
  • Transglutaminases / immunology

Substances

  • Autoantibodies
  • Immunoglobulin A
  • Protein Glutamine gamma Glutamyltransferase 2
  • Transglutaminases
  • GTP-Binding Proteins