Is It Necessary to Screen for Celiac Disease in postmenopausal osteoporotic women?

GONZALEZ D; SUGAI E; GÓMEZ JC; OLIVERI BEATRIZ; GOMEZ ACOTTO C; VEGA E; BAGUR A; MAZURE R; BAI JC; MAUTALEN C

CALCIFIED TISSUE INTERNATIONAL

SPRINGER

Año: 2002 vol. 71 p. 141 - 144

0171-967X

v:* {behavior:url(#default#VML);} o:* {behavior:url(#default#VML);} w:* {behavior:url(#default#VML);} .shape {behavior:url(#default#VML);} st1:*{behavior:url(#ieooui) } &lt;!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0cm; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman"; mso-ansi-language:ES-AR;} @page Section1 {size:595.3pt 841.9pt; margin:1.0cm 3.0cm 1.0cm 2.0cm; mso-header-margin:35.45pt; mso-footer-margin:35.45pt; mso-paper-source:0;} div.Section1 {page:Section1;} --&gt; Abstract. Decreased bone mass is a frequent finding in celiac patients, and subclinical celiac disease (CD) ap- <!--[if !vml]--><!--[endif]-->pears to be unusually overrepresented among patients with idiopathic osteoporosis. Since silent CD may be more common than previously believed, it has been suggested that all osteoporotic patients should be checked for occult CD. The aim ol` this study was to explore the prevalence of CD in a well—deHned popu- lation of postmenopausal osteoporotic women. We evaluated I2? consecutive postmenopausal patients (mean age: 68 years; range: 50-82 years) with verified osteoporosis. The observed prevalence of CD in this group was compared to that observed in a group of T4? women recruited for a population-based study. The screening algorithm used to diagnose CD was based on a 3-level screening using type IgA and IgG antigliadin antibodies (Agra) in all the patients (li" level) followed by antiendoni ·sial antibodies (ErnA) and total IgA (2"´1 level) of samples testing positive, and intestinal biopsy ofpositive cases (3´-Li level). At the end ol` the serological screening, only 1 of 127 osteoporotic women was cli- giblc for jejunal biopsy showing a characteristic celiac flat mucosa (prevalence 7.9 >< 1,000; 95% CI 0.2-43.1). ln addition, CD was diagnosed in 6 ol` T4? women ol` the population-based study (prevalence; S.O>< l,000; 95% Cl 3.3-18,3). There was no signiflcant difference between the two groups. Therefore, our study showed that the prevalence of CD in postmenopausal ost- oporotic women was lower than that reported in pre- vious studies and similar to that of the general population. ln conclusion, although the relatively small size of the group tested does not allow us to be con- clusive, the results suggest that a case finding policy in postmenopausal osteoporosis would have a high cost} benefit ratio except for patients not responding to conventional therapies, or presenting borderline labo- ratory results.