P131 Adult coeliac disease and bone mineral density at the femoral neck, total hip and lumbar spine: an age- and sex-matched case-control study

Abstract

Abstract Background/Aims Coeliac disease (CD) is characterised by intestinal villous atrophy causing malabsorption. Decreased bone mineral density (BMD) has been reported in CD. To the best of our knowledge, no published paper has documented BMD comparisons in detail at different sites. We aim to determine the prevalence of osteoporosis and BMD values at multiple locations in a group of adult CD patients, and compare them to those of age and sex matched controls. Methods We analysed data of adult patients referred for BMD estimation at a district scanner from 2004 to 2018. Dual-energy x-ray absorptiometry was used for all subjects. Patients diagnosed with CD (cases) were age- and sex-matched with subjects referred with no reason for scanning (controls). Additional FRAX(TM) risk factors for osteoporosis were recorded. Comparison was made using chi-squared for categorical values, student's T test for continuous variables, then a univariate followed by a multivariate stepwise logistic model, adjusting for height, weight and body mass index (BMI), were fitted. Results 645 (474 female) patients in the coeliac group were matched with 645 (474 female) controls. There was no significant difference in the mean age (years) at scan: cases 56.24 (SD 14.79) vs controls 56.24 (SD 14.80), p-value 1.00. The coeliac group had a significantly higher proportion of osteoporotic (T-score ≤-2.5 SD) patients at all locations compared to the control group. Cases had significantly lower mean BMD (gcm-2) and mean Z-scores at all locations than the controls. In the multivariate stepwise model, adjusted for height, weight and BMI, only the total hip, lumbar spine and their sub-sites revealed significant associations between having CD and a BMD (gcm-2) in the lowest tertile for the whole cohort. Key results are summarised in Table 1. Conclusion We confirmed that adult CD patients have higher prevalence of osteoporosis and lower BMD values compared to controls. Bone impairment was pronounced at the L1 and L2 vertebrae; least pronounced at the femoral neck. This might be due to CD preferentially damaging trabecular bone, which is predominant in the lumbar spine than femoral neck. Disclosure P. Shtarbanov: None. M. Bukhari: None.