Abstract
Background
Osteoporosis frequently complicates coeliac disease but most studies focus on symptomatic patients at the time of diagnosis. Screening tests have revealed that many individuals with coeliac disease have mild, atypical, or absent symptoms.
Aim
To evaluate the relationship between coeliac disease and osteopenia or osteoporosis in female subjects attending for bone densitometry.
Methods
We studied 371 female subjects attending for bone densitometry, without secondary causes of osteoporosis and included those with normal and with reduced bone mineral density. Mineral density was measured by dual energy X-ray absorptiometry. Screening for coeliac disease was by measurement of anti-endomysial antibody by indirect immunofluorescence.
Results
Two of 115 (1.7%) female subjects with normal bone density and five of 256 (1.9%) female subjects with sub-normal bone density were positive for endomysial antibody. Five subjects who underwent small bowel biopsy had histological changes suggestive of coeliac disease.
Conclusions
In females referred for bone densitometry, endomysial antibody positivity was not more prevalent among those with reduced bone mineral density. Examining only patients with clinically detected coeliac disease may overestimate the frequency of complications. This study does not support population screening for coeliac disease in an area with a high frequency of the condition.
Similar content being viewed by others
References
Johnston SD, Watson RGP, McMillan SA et al. The prevalence of coeliac disease in Northern Ireland.The Lancet 1997; 350: 1370.
Catassi C, Ratsch I-M, Fabiani E et al. Coeliac disease in the year 2000: exploring the iceberg.The Lancet 1994; 343: 200–3.
Not T, Horvath K, Mill D et al. Coeliac disease risk in the USA: high prevalence of antiendomysium antibodies in healthy blood donors.Scand J Gastroenterol 1998; 33: 494–8.
Logan RFA. Screening for coeliac disease — has the time come for mass screening. Acta Paediatr 1996;Suppl 412: 15–9.
Mazure R, Vazquez H, Gonzalez D et al. Bone mineral affection in asymptomatic adult patients with coeliac disease.Am J Gastroenterol 1994; 89: 2130–4.
Molteni N, Caraceni MP, Bardella MT et al. Bone mineral density in adult coeliac patients and the effect of gluten-free diet from childhood.Am J Gastroenterol 1990; 85: 51–3.
Valdimarsson T, Lofman O, Toss G et al. Reversal of osteopenia with diet in adult coeliac disease.Gut 1996; 38: 322–7.
McFarlane XA, Bhalla AK, Robertson DAF. Effect of a gluten free diet on osteopenia in adults with newly diagnosed coeliac disease.Gut 1996; 39: 180–4.
Bai JC, Gonzalez D, Mautalen C et al. Long term effect of gluten restriction on bone mineral density of patients with coeliac disease.Aliment Pharmacol Ther 1997; 11: 157–64.
Mora S, Barera G, Beccio S et al. Bone density and bone metabolism are normal after long-term gluten-free diet in young coeliac patients.Am J Gastroenterol 1999; 94: 398–403.
World Health Organisation. Assessment of fracture risk and its application to screening for postmenopausal osteoporosis.Geneva: WHO, 1994.
Feighery C, Abuzakouk M, Liddy C et al. Endomysial antibody detection using human umbilical cord tissue as substrate: reactivity of cells in Wharton’s jelly.Br J Biomed Sci 1998; 55: 107–10.
Ferreira M, Lloyd Davies S, Butler M et al. Endomysial antibody: is it the best screening test for coeliac disease.Gut 1992; 33: 1633–7.
Mustalahti K, Collin P, Sievanen H et al. Osteopenia in patients with clinically silent coeliac disease warrants screening.The Lancet 1999; 354: 744–5.
Lindh E, Ljunghall S, Larsson K et al. Screening for antibodies against gliadin in patients with osteoporosis.J Intern Med 1992; 231: 403–6.
Cronin CC, Shanahan F. Insulin-dependent diabetes mellitus and coeliac disease.The Lancet 1997; 349: 1096–7.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
O’Leary, C., Feighery, C., Feighery, A. et al. The prevalence of coeliac disease among female subjects having bone densitometry. Ir J Med Sci 171, 145–147 (2002). https://doi.org/10.1007/BF03170502
Issue Date:
DOI: https://doi.org/10.1007/BF03170502