Duerksen Donald R, Leslie William D
University of Manitoba, Winnipeg, Canada.
Can J Gastroenterol. 2010 Feb;24(2):103-7. doi: 10.1155/2010/285036.
Low bone density and osteoporosis have been demonstrated in celiac disease populations in Europe, South America and the United States. Serological testing with tissue transglutaminase (TTG) and immunoglobulin A endomysial (EMA) antibodies is highly specific for celiac disease, while antigliadin antibody (AGA) testing is less specific.
To evaluate the association of celiac serology with reduced bone density in adult women.
A clinical database containing all bone density testing data in the province of Manitoba was linked to a database containing all celiac serology data for the province. The study cohort consisted of 376 women older than 20 years of age with bone density measurements preceding initial celiac serology by six months or less. Bone density was assessed in relation to TTG/EMA and AGA seropositivity, and compared with seronegative controls in age-, height- and weight-adjusted models.
There was significantly lower bone density in TTG/EMA seropositive women than with seronegative controls for all sites tested (lumbar spine, total hip, trochanter, femoral neck; all P<0.05). TTG/ EMA seropositive women also had a significantly higher prevalence of osteoporosis (67.7% versus 44.8%; P<0.05). There was lower bone density at the three hip sites (all P<0.05) in AGA seropositive women, but after excluding TTG/EMA seropositive women, isolated AGA seropositivity showed no significant association with any bone density measurements.
TTG/EMA seropositivity was associated with lower bone density and a higher prevalence of osteoporosis compared with seronegative controls.
在欧洲、南美洲和美国的乳糜泻人群中已证实存在低骨密度和骨质疏松症。组织转谷氨酰胺酶（TTG）和免疫球蛋白A肌内膜（EMA）抗体的血清学检测对乳糜泻具有高度特异性，而抗麦胶蛋白抗体（AGA）检测的特异性较低。
评估成年女性乳糜泻血清学与骨密度降低之间的关联。
将包含曼尼托巴省所有骨密度检测数据的临床数据库与包含该省所有乳糜泻血清学数据的数据库相链接。研究队列由376名年龄超过20岁的女性组成，她们在首次进行乳糜泻血清学检测前六个月或更短时间内进行了骨密度测量。根据TTG/EMA和AGA血清阳性情况评估骨密度，并在年龄、身高和体重调整模型中与血清阴性对照进行比较。
在所有检测部位（腰椎、全髋、大转子、股骨颈；所有P<0.05），TTG/EMA血清阳性女性的骨密度显著低于血清阴性对照。TTG/EMA血清阳性女性的骨质疏松患病率也显著更高（67.7%对44.8%；P<0.05）。AGA血清阳性女性在三个髋部部位的骨密度较低（所有P<0.05），但在排除TTG/EMA血清阳性女性后，单纯AGA血清阳性与任何骨密度测量值均无显著关联。
与血清阴性对照相比，TTG/EMA血清阳性与较低的骨密度和较高的骨质疏松患病率相关。
