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AIM: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 μm 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. CONCLUSION: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.
AIM: 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 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 made a 5 μm thin cryostat section of the 135 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 with 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). Lumba Seropositive patients had lower serum 25 (OH) vitamin D, calcium and higher serum parathormone levels than seronegative patients. CONCLUSION: 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 as identifying risk groups for celiac disease.