Abnormal Skeletal Strength and Microarchitecture in Women With Celiac Disease

Stein, Emily; Rogers, H. Jane; Leib, Alexa; McMahon, Donald J.; Young, Polly; Nishiyama, Kyle K.; Guo, X. Edward; Lewis, Suzanne K.; Green, Peter H.; Shane, Elizabeth

doi:10.1210/jc.2015-1392

Cited by 22 publications

(25 citation statements)

References 39 publications

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“…Lower BMD than expected also affects about half of patients with subclinical CD, who have mild symptoms and often remain undiagnosed [3]. In addition to low BMD, the bone microarchitecture may be deteriorated [4,5] making CD patients more susceptible to low energy fractures. Evidence of increased fracture risk in CD patients is however not consistent [6] and the need for BMD screening is debated.…”

Section: Introductionmentioning

confidence: 99%

Positive IgA against transglutaminase 2 in patients with distal radius and ankle fractures compared to community-based controls

Hjelle

Apalset

Mielnik

et al. 2018

Scandinavian Journal of Gastroenterology

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Backgroud: Patients with celiac disease (CD), including adults with subclinical disease, have low bone mineral density (BMD), deteriorated bone microarchitecture; metanalysis show an increased risk of fracture. Immunoglobulin A (IgA) against transglutaminase 2 (IgA TG2) is a highly reliable marker to detect CD. Main objective: To explore the prevalence of positive IgA TG2 and CD in patients with distal radius and ankle fracture compared to community-based controls. Methods: 400 patients age 40 years or above with distal fractures were included in a casecontrol study. 197 controls were identified from the National Population Registry, those included had never suffered a fracture. BMD was measured, and comorbidities, medications, physical activity, smoking habits, body mass index (BMI) and nutritional factors were registered. Blood analysis to detect common causes of secondary osteoporosis was performed. Results: 2.5% of the fracture patients had positive IgA TG2, compared to 1% in the control group. The odds ratio, adjusted for sex and age, of having positive IgA TG2 was 2.50 (95% CI 0.54-11.56). Conclusions: There were no significantly increased odds of CD in adult patients with fractures compared to controls, however results imply that positive IgA TG2 is more prevalent in fracture patients than in controls. This study indicates that universal screening for CD in fracture patients is not warranted, but supports current clinical practice in Norway to suspect and investigate for CD in patients with fracture, osteoporosis and other risk factors for CD.

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Section: Introductionmentioning

confidence: 99%

Positive IgA against transglutaminase 2 in patients with distal radius and ankle fractures compared to community-based controls

Hjelle

Apalset

Mielnik

et al. 2018

Scandinavian Journal of Gastroenterology

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“…When making a diagnosis of CD, it is very important to know if the patient suffers from the different symptoms; since studies that diagnose CD are invasive analyses [4,5,9,10,20,22,24,26,27,[30][31][32]37,39,41,43,45,46,[49][50][51]58]. Therefore, before requesting the analyses, it is useful to perform a Celiac Symptom Index test to identify the symptoms apart from the clear use of the clinical history; in this way, a better diagnosis can be made [57].…”

Section: Discussionmentioning

confidence: 99%

“…Another of the least performed studies for the diagnosis of CD is the immunoassay metric [40]; in this, the level of antigens and antibodies is measured and they use the serum endomysia antibody [1,19,20,22,33,35,37]. Different articles present that sensitivity to gluten or development of CD were related to a genetic factor.…”

Section: Characteristic Of the Included Studiesmentioning

confidence: 99%

“…In the different studies, factors that help to measure fertility were measured, such as the anti-Müllerian hormone, since we speak of middle-aged adult women [39]. They also used routine physical examinations such as weight [5,7,10,20,26,27,32,51], height [5,7,10,20,26,27,32,51], body mass index (BMI, a formula that uses weight and height) [5,7,10,20,26,27,32,51], fat mass, and energy consumption [4,5], which were compared with their clinical analysis to be able to complement the patient's profile and to make a diagnosis. Analysis of the food consumed can also be found in order to help the patient with his or her nutritional treatment, which is the only known treatment for CD [5].…”

Section: Characteristic Of the Included Studiesmentioning

confidence: 99%

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Tools Used to Measure the Physical State of Women with Celiac Disease: A Review with a Systematic Approach

Martínez-Rodríguez

Loaiza-Martínez

Sánchez-Sánchez

et al. 2020

IJERPH

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Celiac disease (CD) is an immunological disorder that mainly affects the small intestine, generating an inflammatory process in response to the presence of gluten (a protein). Autoimmune diseases are part of a group of diseases that are difficult to diagnose without a specific protocol or consensus to detect them due to the number of symptoms and diseases with which it has a relationship. Therefore, the aim of this review was to analyze the diagnostic tools of CD used in middle-aged women, to compare the use and effectiveness of the different tools, and to propose a strategy for the use of the tools based on the results found in the literature. The present research followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. The search was conducted in the following databases: Scielo, PubMed, Web of Science, and Worldwide Science org. In the initial literature search, 2004 titles and relevant abstracts were found. Among them, 687 were duplicates, leaving 1130 articles. Based on the inclusion criteria, only 41 articles passed the selection process; 4 main types of analyses appear in the studies: blood tests, questionnaires, clinical history, and biopsy. It can be said that none of the analyses have a 100% reliability since most of them can present false negatives; therefore, the best way to diagnose celiac disease up to now is through a combination of different tests (Immunoglobulin A and small intestinal biopsy).

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“…Other factors include chronic inflammation, with increased cytokine levels that interfere with bone growth and autoimmune factors . Skeletal fragility, as measured by microarchitecture by high‐resolution computed tomography, is also diminished in individuals with newly diagnosed CD . Improvement of bone density often occurs after institution of the gluten‐free diet, though the improvement can be modest …”

Section: Discussionmentioning

confidence: 99%

Systematic review with meta‐analysis: the prevalence of coeliac disease in patients with osteoporosis

Laszkowska

Mahadev

Sundström

et al. 2018

Aliment Pharmacol Ther

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Abnormal Skeletal Strength and Microarchitecture in Women With Celiac Disease

Cited by 22 publications

References 39 publications

Positive IgA against transglutaminase 2 in patients with distal radius and ankle fractures compared to community-based controls

Positive IgA against transglutaminase 2 in patients with distal radius and ankle fractures compared to community-based controls

Tools Used to Measure the Physical State of Women with Celiac Disease: A Review with a Systematic Approach

Systematic review with meta‐analysis: the prevalence of coeliac disease in patients with osteoporosis

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