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The recent report by Thomason and colleagues (Gut 2003;52:518–22) which failed to detect a significant increase in fractures experienced by treated coeliacs might reassure many patients and physicians. However, this study, and the accompanying commentary by Compston (Gut 2003;52:459), need full and critical assessment before changes in practice are adopted and coeliacs are no longer targeted to be screened for osteoporosis.
It is not surprising that no significant increase in fracture could be detected in this population of well treated coeliacs, given previous findings. The American Gastroenterology Association recently reviewed studies of osteoporosis in gastrointestinal diseases, including coeliac disease, according to standard levels of evidence.1 All such studies have shown low mean bone mineral density (BMD) around the …
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