Should patients with osteoporosis be screened for celiac disease?

There seems to be enough celiac disease in women with osteoporosis to justify serologic screening for the GI ailment in all women with osteoporosis, according to the results of a large screening trial (3.4 vs. 0.2%). Researchers performed serologic screening for celiac disease in 266 women with osteoporosis and 574 without the bone-thinning disease. Those with positive serologic test results for IgA antitissue transglutaminase (anti-TTG) or IgA antiendomysial antibody were offered endoscopic intestinal biopsy.

Nine osteoporotic women and one nonosteoporotic woman had positive biopsy results. The researchers found that the more severe the celiac disease, the more severe the osteoporosis. More importantly, treating patients found to be positive for celiac disease with a gluten-free diet resulted in marked improvement in bone mineral density.

The authors of the study concluded that at an approximate cost of $45 for anti-TTG testing and a prevalence rate of celiac disease among osteoporotic women of 3.4%, identifying a patient with celiac disease via serologic screening would cost about $1,500.