Coeliac disease-specific tissue transglutaminase autoantibodies are associated with osteoporosis and related fractures in middle-aged women

被引:30
作者
Agardh, Daniel [1 ,2 ]
Bjorck, Sara [1 ,2 ]
Agardh, Carl-David [2 ]
Lidfeldt, Jonas [2 ]
机构
[1] Lund Univ, Malmo Univ Hosp, Unit Diabet & Coeliac Dis, S-22100 Lund, Sweden
[2] Lund Univ, Malmo Univ Hosp, Dept Clin Sci, S-22100 Lund, Sweden
关键词
Coeliac disease; fracture; osteoporosis; screening; tissue transglutaminase; women; BONE-MINERAL DENSITY; ANTITISSUE TRANSGLUTAMINASE; DIAGNOSTIC-ACCURACY; CLINICAL-FEATURES; IMMUNOGLOBULIN-A; PREVALENCE; CHILDREN; RISK; ANTIBODIES; IGA;
D O I
10.1080/00365520902718929
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objective. To investigate whether the serological marker for coeliac disease, tissue transglutaminase autoantibody (tTGAb), is associated with decreased bone mass density (BMD) and increased frequency of fractures in middle-aged women screened for osteoporosis. Material and methods. The study comprised 6480 women (mean age 56 years, range 50-64) who answered a number of questionnaires and who underwent dual X-ray absorptiometry of the wrist bone. Serum samples were analysed for tTGAb using radioligand binding assays. A tTGAb level of 4 U/ml was used to determine a positive value and a level of 17 U/ml was used as an alternative discrimination of high levels. Results. A tTGAb level 4 U/ml was found among 90/6480 (1.4%) women and correlated with lower BMD (multiple linear regression coefficient -382.1; 95% CI = - 673.6-90.7, p=0.011) and with fracture frequency (r=0.18, p=0.023). The 59 women with tTGAb levels 17 U/ml had a lower BMD (0.410.08 g/cm2 versus 0.440.08 g/cm2, p=0.001) and a lower T-score (-1.401.28 versus -0.901.40, p=0.003) as well as a higher prevalence of osteoporosis (13.4% versus 6.5%, p=0.008) compared with the remaining 6421 women with tTGAb levels 17 U/ml. Furthermore, fracture frequency was more pronounced in women with tTGAb levels 17 U/ml, among whom 19/59 (32.2%) had fractures during the study period compared with 1204/6421 (18.8%) among women with tTGAb levels 17 U/ml (p=0.009). Conclusions. High levels of tTGAb indicating coeliac disease are associated with lower BMD and higher fracture frequency in women between 50 and 64 years of age. Osteometry is therefore warranted in middle-aged women detected with tTGAb.
引用
收藏
页码:571 / 578
页数:8
相关论文
共 48 条
[31]   THE INTERACTION BETWEEN DIFFERENT DOMAINS OF STAPHYLOCOCCAL PROTEIN-A AND HUMAN POLYCLONAL IGG, IGA, IGM AND F(AB')2 - SEPARATION OF AFFINITY FROM SPECIFICITY [J].
LJUNGBERG, UK ;
JANSSON, B ;
NISS, U ;
NILSSON, R ;
SANDBERG, BEB ;
NILSSON, B .
MOLECULAR IMMUNOLOGY, 1993, 30 (14) :1279-1285
[32]   IgA anti-tissue transglutaminase as a diagnostic marker of gluten sensitive enteropathy [J].
Lock, RJ ;
Pitcher, MCL ;
Unsworth, DJ .
JOURNAL OF CLINICAL PATHOLOGY, 1999, 52 (04) :274-277
[33]   Prevalence of low femoral bone density in older US adults from NHANES III [J].
Looker, AC ;
Orwoll, ES ;
Johnston, CC ;
Lindsay, RL ;
Wahner, HW ;
Dunn, WL ;
Calvo, MS ;
Harris, TB ;
Heyse, SP .
JOURNAL OF BONE AND MINERAL RESEARCH, 1997, 12 (11) :1761-1768
[34]   Coeliac disease and the risk of fractures - a general population-based cohort study [J].
Ludvigsson, J. F. ;
Michaelsson, K. ;
Ekbom, A. ;
Montgomery, S. M. .
ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2007, 25 (03) :273-285
[35]   Prevalence of celiac disease among children in Finland [J].
Maki, M ;
Mustalahti, K ;
Kokkonen, J ;
Kulmala, P ;
Haapalahti, M ;
Karttunen, T ;
Ilonen, J ;
Laurila, K ;
Dahlbom, I ;
Hansson, T ;
Hopfl, P ;
Knip, M .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 348 (25) :2517-2524
[36]  
Mather KJ, 2001, AM J GASTROENTEROL, V96, P120
[37]   Prevalence of undiagnosed coeliac syndrome in osteoporotic women [J].
Nuti, R ;
Martini, G ;
Valenti, R ;
Giovani, S ;
Salvadori, S ;
Avanzati, A .
JOURNAL OF INTERNAL MEDICINE, 2001, 250 (04) :361-366
[38]   Systematic review and meta-analysis of observational studies on the prevalence of fractures in coeliac disease [J].
Olmos, M. ;
Antelo, M. ;
Vazquez, H. ;
Smecuol, E. ;
Maurino, E. ;
Bai, J. C. .
DIGESTIVE AND LIVER DISEASE, 2008, 40 (01) :46-53
[39]   The diagnostic accuracy of serologic tests for celiac disease:: A systematic review [J].
Rostom, A ;
Dubé, C ;
Cranney, A ;
Saloojee, N ;
Sy, R ;
Garritty, C ;
Sampson, M ;
Zhang, L ;
Yazdi, F ;
Mamaladze, V ;
Pan, I ;
Macneil, J ;
Mack, D ;
Patel, D ;
Moher, D .
GASTROENTEROLOGY, 2005, 128 (04) :S38-S46
[40]   Tissue transglutaminase autoantibody enzyme-linked immunosorbent assay in detecting celiac disease [J].
Sulkanen, S ;
Halttunen, T ;
Laurila, A ;
Kolho, KL ;
Korponay-Szabó, IR ;
Sarnesto, A ;
Savilahti, E ;
Collin, P ;
Mäki, M .
GASTROENTEROLOGY, 1998, 115 (06) :1322-1328