A serological diagnosis of coeliac disease is associated with osteoporosis in older Australian adults

Michael D.E. Potter, Marjorie M. Walker, Stephen Hancock, Elizabeth Holliday, Gregory Brogan, Michael Jones, Mark McEvoy, Michael Boyle, Nicholas J. Talley, John Attia

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Previously thought to be mainly a disorder of childhood and early adult life, coeliac disease (CeD) is increasingly diagnosed in older adults. This may be important given the association between CeD and osteoporosis. The primary aim of this study was to determine the seroprevalence of undiagnosed CeD (‘at-risk serology’) in an older Australian community and relate this to a diagnosis of osteoporosis and fractures during a follow-up period of 12 years. We included participants from the Hunter Community Study (2004–2007) aged 55–85, who had anti-tissue transglutaminase (tTG) titres, human leukocyte antigen (HLA) genotypes, and bone mineral density measurements at baseline. Follow-up data included subsequent diagnosis of CeD and fractures using hospital information. ‘At-risk’ serology was defined as both tTG and HLA positivity. Complete results were obtained from 2122 patients. The prevalence of ‘at-risk’ serology was 5%. At baseline, 3.4% fulfilled criteria for a diagnosis of osteoporosis. During a mean of 9.7 years of follow-up, 7.4% of the cohort suffered at least one fracture and 0.7% were subsequently diagnosed with CeD. At-risk serology was significantly associated with osteoporosis in a multivariate model (odds ratio 2.83, 95% confidence interval 1.29–6.22); there was insufficient power to look at the outcome of fractures. The results of this study demonstrate that at-risk CeD serology was significantly associated with concurrent osteoporosis but not future fractures. Most individuals with a serological diagnosis of CeD were not diagnosed with CeD during the follow-up period according to medical records. Coeliac disease likely remains under-diagnosed.

LanguageEnglish
Article number849
Pages1-12
Number of pages12
JournalNutrients
Volume10
Issue number7
DOIs
Publication statusPublished - Jul 2018

Fingerprint

celiac disease
serodiagnosis
osteoporosis
Celiac Disease
Osteoporosis
Serology
protein-glutamine gamma-glutamyltransferase
HLA Antigens
Seroepidemiologic Studies
bone density
childhood
seroprevalence
Bone Density
odds ratio
Medical Records
confidence interval
Odds Ratio
Genotype
serology
Confidence Intervals

Bibliographical note

Copyright the Author(s) 2018. Version archived for private and non-commercial use with the permission of the author/s and according to publisher conditions. For further rights please contact the publisher.

Keywords

  • coeliac disease
  • osteoporosis
  • fractures

Cite this

Potter, M. D. E., Walker, M. M., Hancock, S., Holliday, E., Brogan, G., Jones, M., ... Attia, J. (2018). A serological diagnosis of coeliac disease is associated with osteoporosis in older Australian adults. Nutrients, 10(7), 1-12. [849]. https://doi.org/10.3390/nu10070849
Potter, Michael D.E. ; Walker, Marjorie M. ; Hancock, Stephen ; Holliday, Elizabeth ; Brogan, Gregory ; Jones, Michael ; McEvoy, Mark ; Boyle, Michael ; Talley, Nicholas J. ; Attia, John. / A serological diagnosis of coeliac disease is associated with osteoporosis in older Australian adults. In: Nutrients. 2018 ; Vol. 10, No. 7. pp. 1-12.
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abstract = "Previously thought to be mainly a disorder of childhood and early adult life, coeliac disease (CeD) is increasingly diagnosed in older adults. This may be important given the association between CeD and osteoporosis. The primary aim of this study was to determine the seroprevalence of undiagnosed CeD (‘at-risk serology’) in an older Australian community and relate this to a diagnosis of osteoporosis and fractures during a follow-up period of 12 years. We included participants from the Hunter Community Study (2004–2007) aged 55–85, who had anti-tissue transglutaminase (tTG) titres, human leukocyte antigen (HLA) genotypes, and bone mineral density measurements at baseline. Follow-up data included subsequent diagnosis of CeD and fractures using hospital information. ‘At-risk’ serology was defined as both tTG and HLA positivity. Complete results were obtained from 2122 patients. The prevalence of ‘at-risk’ serology was 5{\%}. At baseline, 3.4{\%} fulfilled criteria for a diagnosis of osteoporosis. During a mean of 9.7 years of follow-up, 7.4{\%} of the cohort suffered at least one fracture and 0.7{\%} were subsequently diagnosed with CeD. At-risk serology was significantly associated with osteoporosis in a multivariate model (odds ratio 2.83, 95{\%} confidence interval 1.29–6.22); there was insufficient power to look at the outcome of fractures. The results of this study demonstrate that at-risk CeD serology was significantly associated with concurrent osteoporosis but not future fractures. Most individuals with a serological diagnosis of CeD were not diagnosed with CeD during the follow-up period according to medical records. Coeliac disease likely remains under-diagnosed.",
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Potter, MDE, Walker, MM, Hancock, S, Holliday, E, Brogan, G, Jones, M, McEvoy, M, Boyle, M, Talley, NJ & Attia, J 2018, 'A serological diagnosis of coeliac disease is associated with osteoporosis in older Australian adults', Nutrients, vol. 10, no. 7, 849, pp. 1-12. https://doi.org/10.3390/nu10070849

A serological diagnosis of coeliac disease is associated with osteoporosis in older Australian adults. / Potter, Michael D.E.; Walker, Marjorie M.; Hancock, Stephen; Holliday, Elizabeth; Brogan, Gregory; Jones, Michael; McEvoy, Mark; Boyle, Michael; Talley, Nicholas J.; Attia, John.

In: Nutrients, Vol. 10, No. 7, 849, 07.2018, p. 1-12.

Research output: Contribution to journalArticleResearchpeer-review

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