The Prevalence of Celiac Disease in a Fracture Liaison Service Population
- PDF / 478,203 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 48 Downloads / 169 Views
ORIGINAL RESEARCH
The Prevalence of Celiac Disease in a Fracture Liaison Service Population Irma J. A. de Bruin1,2 · Lisanne Vranken1,2 · Caroline E. Wyers1,2 · Robert Y. van der Velde1,2 · Thera A. M. Trienekens3 · Sjoerd Kaarsemaker4 · Heinrich M. J. Janzing5 · Frank L. Wolters6 · Siep Wouda7 · Piet P. M. M. Geusens8,9 · Joop P. W. van den Bergh1,2,9 Received: 13 May 2020 / Accepted: 8 July 2020 © The Author(s) 2020
Abstract Celiac disease (CD) is a known risk factor for osteoporosis and fractures. The prevalence of CD in patients with a recent fracture is unknown. We therefore systematically screened patients at a fracture liaison service (FLS) to study the prevalence of CD. Patients with a recent fracture aged ≥ 50 years were invited to VieCuri Medical Center’s FLS. In FLS attendees, bone mineral density (BMD) and laboratory evaluation for metabolic bone disorders and serological screening for CD was systematically evaluated. If serologic testing for CD was positive, duodenal biopsies were performed to confirm the diagnosis CD. Data were collected in 1042 consecutive FLS attendees. Median age was 66 years (Interquartile range (IQR) 15), 27.6% had a major and 6.9% a hip fracture, 26.4% had osteoporosis and 50.8% osteopenia. Prevalent vertebral fractures were found in 29.1%. CD was already diagnosed in two patients (0.19%), one still had a positive serology. Three other patients (0.29%) had a positive serology for CD (one with gastro-intestinal complaints). In two of them, CD was confirmed by duodenal histology (0.19%) and one refused further evaluation. The prevalence of biopsy-proven CD was therefore 0.38% (4/1042) of which 0.19% (2/1042) was newly diagnosed. The prevalence of CD in patients with a recent fracture at the FLS was 0.38% and within the range of reported prevalences in the Western-European population (0.33–1.5%). Newly diagnosed CD was only found in 0.19%. Therefore, standard screening for CD in FLS patients is not recommended. Keywords Fracture liaison service · Celiac disease · Osteoporosis · Fractures
Introduction Celiac disease (CD) is an autoimmune enteropathy induced by dietary proteins in wheat, rye, and barley. The presentation of symptoms widely varies. In 2012, the following * Joop P. W. van den Bergh [email protected] 1
2
3
4
Department of Internal Medicine, VieCuri Medical Center, Tegelseweg 210, PO Box 1926, 5900 BX Venlo, The Netherlands NUTRIM School of Nutrition and Translational Research in Metabolism, Department of Internal Medicine, Maastricht University Medical Centre+ (MUMC+), PO Box 616, 6200 MD Maastricht, The Netherlands Department of Medical Microbiology, VieCuri Medical Center, Venlo, The Netherlands Department of Orthopaedic Surgery, VieCuri Medical Center, Venlo, The Netherlands
Oslo definitions for CD were stated: ‘classical CD presents with signs and symptoms of malabsorption. Besides malabsorption, other symptoms of diarrhea, steatorrhea, weight loss, or growth failure are required. Non-classical CD presents with gastro-inte
Data Loading...
