title: Screening for asymptomatic celiac disease among patients referred for bone densitometry measurement.
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.
authors.affiliation: Department of Medicine, University College Cork, National University of Ireland Cork, Ireland. f.drummond@ucc.ie
authors.forename: F J
authors.initials: FJ
authors.lastname: Drummond
authors.forename: P
authors.initials: P
authors.lastname: Annis
authors.forename: K
authors.initials: K
authors.lastname: O'Sullivan
authors.forename: F
authors.initials: F
authors.lastname: Wynne
authors.forename: M
authors.initials: M
authors.lastname: Daly
authors.forename: F
authors.initials: F
authors.lastname: Shanahan
authors.forename: K A
authors.initials: KA
authors.lastname: Quane
authors.forename: M G
authors.initials: MG
authors.lastname: Molloy
mesh_terms: D015502:Absorptiometry, Photon; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000175:diagnosis / Q000276:immunology; D002446:Celiac Disease / Q000175:diagnosis / Q000453:epidemiology*; D003627:Data Interpretation, Statistical; D004947:Esophagus / Q000276:immunology; D005260:Female; D019204:GTP-Binding Proteins / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood / Q000276:immunology; D007494:Ireland / Q000453:epidemiology; D008159:Lumbar Vertebrae / Q000737:chemistry; D008403:Mass Screening; D008875:Middle Aged; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases / Q000276:immunology
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins