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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 3^1(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 references^2-3 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.

In addition, it is stated that all . . . [Full Text of this Article]

AUTHOR INFORMATION
Robert Hoyt, MD

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