Osteoporosis: meta-analysis argues against routine screening for celiac disease

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Takeaway

  • A meta-analysis finds that the prevalence of celiac disease (CD) among patients with osteoporosis is 1 in 62, or 1.6%.
  • This prevalence is not much different from the prevalence of CD in the general population (0.25%-1%).

Why this matters

  • Contrary to current guidelines, findings argue against routine screening for CD among patients with osteoporosis.

Study design

  • Meta-analysis of 8 studies of biopsy-confirmed CD (n=3188) that met eligibility criteria after search of PubMed, Medline, and EMBASE.
  • Funding: NIH; Swedish Research Council; Swedish Society of Medicine.

Key results

  • 59 people had CD among 3188 patients with osteoporosis (1.9%).
  • Biopsy-confirmed CD had prevalence (in weighted pooled analysis) of 1.6% (95% CI, 1.1%-2.0%) in patients with osteoporosis.
  • Heterogeneity across studies was moderate (I2, 40.1%) and was affected by the prevalence of CD in the general population.
  • Pooled analysis prevalence of CD in osteoporosis was comparable to that of the general population (1.6% vs 0.25%-1%).
  • The pooled prevalence of CD in studies restricted to women with osteoporosis was higher, at 2.3%.
  • The pooled prevalence of CD in patients with osteoporosis remained at 1.6% when adding 4 more studies (n=814) that included nonbiopsy-confirmed CD.

Limitations

  • Study lacked data on severity of osteoporosis.