Prevalence of IgA-antiendomysial antibody in a patient cohort with idiopathic low bone mineral density.
OBJECTIVE
To investigate the frequency of serum IgA-antiendomysial antibody positivity in patients with low bone mineral density and to assess the risk group for screening of celiac disease.


METHODS
One hundred and thirty-five patients (14 male, 121 female) with idiopathic low bone mineral density were evaluated. The median age was 57.2 years (24-81). Antiendomysial antibody was determined by the immunofluorescence method using a commercial kit (INOVA Diagnostics Inc., CA, USA), which employs a 5 microm thin cryostat section of monkey esophagus as a substrate.


RESULTS
Of the 135 patients evaluated, 13 were found to have positive IgA antiendomysial antibody test (9.6%) response. None of the patients had IgA deficiency. Endoscopic appearance and histological examination were normal in all of these patients. Seropositive patients had significantly lower age (48.9 +/- 4.3 vs 59.2 +/- 6.2, P < 0.05), higher ratio of male gender (61.5% vs 4.9%, P < 0.01) and pre-menopausal status (8.7% vs 1.3%, P < 0.01). Lumbar spine and femoral neck z-scores, but not t-scores were significantly lower in seropositive patients. Seropositive patients had lower serum 25 (OH) vitamin D, calcium and higher serum parathormone levels than seronegative patients.


CONCLUSIONS
The screening of celiac disease in idiopathic osteoporosis should be restricted to patients without classical risk factors (younger, pre-menopausal, male gender) for osteoporosis. Bone mineral density measurements using z-scores should be considered for identifying risk groups for celiac disease.
Karakan
T
T
Gazi University, Faculty of Medicine, Department of Gastroenterology, Ankara, Turkey. tkarakan@gmail.com
Ozyemisci-Taskiran
O
O
Gunendi
Z
Z
Atalay
F
F
Tuncer
C
C
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood*; D015519:Bone Density / Q000276:immunology*; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000209:etiology / Q000276:immunology; D002118:Calcium / Q000097:blood; D002446:Celiac Disease / Q000097:blood / Q000150:complications* / Q000276:immunology; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007070:Immunoglobulin A / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000097:blood / Q000209:etiology / Q000276:immunology; D010281:Parathyroid Hormone / Q000097:blood; D015995:Prevalence; D011446:Prospective Studies; D012155:Reticulin / Q000276:immunology; D012307:Risk Factors; D012737:Sex Factors; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood
D001323:Autoantibodies; D007070:Immunoglobulin A; D010281:Parathyroid Hormone; D012155:Reticulin; D014807:Vitamin D; C104450:25-hydroxyvitamin D; D002118:Calcium