Serological screening for celiac disease in premenopausal women with idiopathic osteoporosis

The aim of this study was to perform serological testing to screen for celiac disease (CD) among premenopausal women with idiopathic osteoporosis and to investigate the bone turnover in patients who are seropositive for CD. We studied 89 premenopausal women with idiopathic osteoporosis. The serological screening protocol was based on a two-level evaluation. The first level consisted of determining serum level of IgA antigliadin antibodies (AGA). Subjects who were negative for IgA AGA were classified as not having CD, while samples testing positive for IgA AGA underwent a second level of the screening process. For the second level of screening, the serum IgA endomysial antibody (EMA) test was performed. Bone metabolism was evaluated by serum calcium (Ca), phosphorus, alkaline phosphatase, parathyroid hormone (PTH), 25 (OH) vitamin D, osteocalcin (OC), urinary deoxypyridinoline (dPD), and 24-h urinary calcium levels. Of the 89 patients evaluated, 17 were found to have positive IgA AGA tests (19%) and 9 were found to be positive for EMA (10.11%). EMA-positive patients showed lower values of serum Ca (p < 0.05) and 25 (OH) vitamin D (p < 0.01) and significantly higher values of PTH (p < 0.01) compared with the EMA-negative patients. The level of urinary dPD was found to be significantly higher in EMA-positive patients (p < 0.05). The results of this study suggest that all patients with idiopathic osteoporosis should be screened for CD by measurement of EMA. Additionally, we believe that serological screening for CD and detection of such patients will allow determination of the most convenient treatment strategies for osteoporosis.