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Editor's Correspondence
September 12, 2005

Celiac Disease and Osteoporosis

Arch Intern Med. 2005;165(16):1922-1923. doi:10.1001/archinte.165.16.1922-b

The article by Stenson et al1 determined that the prevalence of celiac disease in their bone clinic was 3.4% compared with 0.2% in nonosteoporotic control patients after screening tests. One of the tests was the 25-hydroxyvitamin D level, and in Table 31(p395) the authors state the normal range to be 0 to 55 ng/mL (0-137.3 nmol/L) but provide no references. Although the lower limit of normal for 25-hydroxyvitamin D is controversial, several references2,3 use 12 to 15 ng/mL (30.0-37.4 nmol/L) as the lower limit of normal. Of the 9 patients found to have celiac disease, 6 had levels of 15 ng/mL or lower (≤37.4 nmol/L), suggesting possible 25-hydroxyvitamin D deficiency. What percentage of the control group had levels of 15 ng/mL or lower (≤37.4 nmol/L)? Urinary calcium levels would have been interesting but remain controversial in the workup of secondary osteoporosis.

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