title: Celiac disease is not increased in women with hip fractures and low vitamin D levels.
abstract: OBJECTIVE
  Celiac disease is associated with decreased bone density; however, the risk of fractures in celiac disease patients is unclear. We compared the prevalence of celiac disease between a group of women with hip fractures and a group of women undergoing elective joint replacement surgery and the association between celiac disease and vitamin D levels.
  
  
  METHODS
  Two hundred eight community dwelling and postmenopausal women were recruited from Boston, MA (n=81) and Baltimore, MD (n=127). We measured tissue transglutaminase IgA by ELISA to diagnose celiac disease and 25-hydroxyvitamin D (25(OH)D) levels by radioimmunoassay in both women with hip fractures (n=157) and a control group (n=51) of total hip replacement subjects from Boston. Subjects were excluded if they took any medications or had medical conditions that might affect bone.
  
  
  RESULTS
  Median serum 25(OH)D levels were significantly lower (p< 0.0001) in the hip fracture cohorts compared to the elective joint replacement cohort (14.1 ng/ml vs. 21.3 ng/ml, respectively). There were no differences in the percentage of subjects with a positive tissue transglutaminase in the women with hip fractures versus the control group (1.91% vs. 1.96%, respectively).
  
  
  CONCLUSIONS
  Vitamin D levels are markedly reduced in women with hip fractures, however hip fracture patients did not show a higher percentage of positive tissue transglutaminase levels compared with controls. These data suggest that routine testing for celiac disease among hip fracture patients may not be necessary in the absence of clinical signs and symptoms, although data from larger studies among hip fracture subjects are needed.
authors.affiliation: Skeletal Health and Osteoporosis Center and Bone Density Unit, Division of Endocrinology, Diabetes and Hypertension, Professor of Medicine, Harvard Medical School, Brigham and Women's Hospital, 221 Longwood Avenue, Boston, MA 02115, USA. MLEBOFF@PARTNERS.ORG
authors.forename: M S
authors.initials: MS
authors.lastname: Leboff
authors.forename: H
authors.initials: H
authors.lastname: Cobb
authors.forename: L Y
authors.initials: LY
authors.lastname: Gao
authors.forename: W
authors.initials: W
authors.lastname: Hawkes
authors.forename: J
authors.initials: J
authors.lastname: Yu-Yahiro
authors.forename: N S
authors.initials: NS
authors.lastname: Kolatkar
authors.forename: J
authors.initials: J
authors.lastname: Magaziner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019644:Arthroplasty, Replacement, Hip; D015142:Baltimore; D001842:Bone and Bones / Q000473:pathology; D001900:Boston; D016022:Case-Control Studies; D002446:Celiac Disease / Q000097:blood* / Q000150:complications / Q000453:epidemiology*; D015331:Cohort Studies; D005260:Female; D019204:GTP-Binding Proteins / Q000378:metabolism; D006620:Hip Fractures / Q000097:blood* / Q000150:complications; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D015995:Prevalence; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases / Q000378:metabolism; D014807:Vitamin D / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood* / Q000150:complications
chemical_list: D007070:Immunoglobulin A; D014807:Vitamin D; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins