Screening for celiac disease in patients with osteoporosis

Joint Bone Spine. 2009 Mar;76(2):162-5. doi: 10.1016/j.jbspin.2008.06.016. Epub 2009 Jan 29.


Objective: Whether patients with osteoporosis should be screened for celiac disease is controversial. The objective of this study was to measure the prevalence of asymptomatic celiac disease in a cohort of patients with osteoporosis.

Methods: We studied 140 patients (133 postmenopausal women and 7 men) aged 40-75 years (mean age, 62.9+/-9.4 years) with primary osteoporosis diagnosed by absorptiometry (spine or hip T-score <-2.5SD). We routinely measured serum and urinary calcium, serum phosphate, alkaline phosphatase, 25-OH-vitamin D3, and IgG and IgA antigliadin antibodies. Patients with positive antigliadin antibody tests were tested for antitransglutaminase antibodies.

Results: A history of fractures were noted in 52 (37%) patients, with 57 peripheral and 54 vertebral fractures overall. Vitamin D deficiency was found in 60 (43%) patients. IgG antigliadin antibodies were positive in 11 (8%) patients, IgA antigliadin antibodies in 11 (8%) patients, and both antibodies in 4 (3%) patients. Antitransglutaminase antibodies were negative in all patients. No significant differences in laboratory test or absorptiometry results were found between patients with versus without IgA antigliadin antibodies. The T-score at the spine was nonsignificantly lower in patients with than without IgG antigliadin antibodies (-3.17+/-0.49 and -2.82+/-0.77, P=0.076).

Conclusion: We found no excess risk of celiac disease in our cohort of patients with osteoporosis. Despite the small sample size, our results cast doubt on the need for celiac-disease screening in osteoporotic patients who have no gastrointestinal symptoms.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Anti-Idiotypic / blood
  • Biomarkers / blood
  • Celiac Disease / blood
  • Celiac Disease / complications
  • Celiac Disease / epidemiology*
  • Cohort Studies
  • Comorbidity
  • Female
  • France / epidemiology
  • Gliadin / immunology
  • Humans
  • Immunoglobulin A / immunology
  • Male
  • Mass Screening
  • Middle Aged
  • Osteoporosis / blood
  • Osteoporosis / complications
  • Osteoporosis / epidemiology*


  • Antibodies, Anti-Idiotypic
  • Biomarkers
  • Immunoglobulin A
  • Gliadin