Agardh Daniel, Björck Sara, Agardh Carl-David, Lidfeldt Jonas
Unit of Diabetes and Coeliac Disease, Malmö University Hospital, Lund University, Sweden.
Scand J Gastroenterol. 2009;44(5):571-8. doi: 10.1080/00365520902718929.
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.
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.
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 >or=17 U/ml had a lower BMD (0.41+/-0.08 g/cm(2) versus 0.44+/-0.08 g/cm(2), p=0.001) and a lower T-score (-1.40+/-1.28 versus -0.90+/-1.40, 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 >or=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).
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.
研究乳糜泻的血清学标志物组织转谷氨酰胺酶自身抗体（tTGAb）是否与骨质疏松筛查中年女性的骨密度（BMD）降低及骨折发生率增加有关。
本研究纳入6480名女性（平均年龄56岁，范围50 - 64岁），她们回答了一系列问卷并接受了腕骨双能X线吸收测定。使用放射性配体结合测定法分析血清样本中的tTGAb。tTGAb水平>4 U/ml被用于确定阳性值，>17 U/ml作为高水平的另一种判别标准。
6480名女性中有90名（1.4%）tTGAb水平>4 U/ml，且与较低的骨密度相关（多元线性回归系数 -382.1；95%置信区间 = -673.6 - 90.7，p = 0.011）以及与骨折发生率相关（r = 0.18，p = 0.023）。59名tTGAb水平≥17 U/ml的女性骨密度较低（0.41±0.08 g/cm² 对比 0.44±0.08 g/cm²，p = 0.001），T值较低（-1.40±1.28对比 -0.90±1.40，p = 0.003），且骨质疏松患病率较高（13.4%对比6.5%，p = 0.008），与其余6421名tTGAb水平<17 U/ml的女性相比亦是如此。此外，tTGAb水平≥17 U/ml的女性骨折发生率更高，在研究期间，其中19/59（32.2%）发生了骨折，而tTGAb水平<17 U/ml的女性中这一比例为1204/6421（18.8%）（p = 0.009）。
表明乳糜泻的高水平tTGAb与50至64岁女性较低的骨密度和较高骨折发生率相关。因此，对检测出tTGAb的中年女性进行骨测量是必要的。
