Prevalence and risk factors of musculoskeletal symptoms among treated coeliac disease patients.

Varying musculoskeletal symptoms, such as joint pain and myalgia, are recognized as possible extraintestinal complaints of coeliac disease (CeD), but little is known about the prevalence and risk factors of these symptoms. In this study the aim was to evaluate the prevalence of and factors associated with self-reported musculoskeletal symptoms among adult CeD patients on a gluten-free diet (GFD). The presence of current musculoskeletal symptoms was studied in 614 CeD patients on a GFD and 539 of their non-CeD relatives by a systematic interview. The association between musculoskeletal symptoms and various patient-related factors was investigated using logistic regression. CeD patients reported more often current musculoskeletal symptoms than controls (37.8% vs. 22.8%, p < 0.001). CeD was an independent risk factor for musculoskeletal symptoms even after adjusting for age, gender and previously diagnosed co-morbidities, including autoimmune thyroid disease, osteoarthritis and osteoporosis/osteopenia (odds ratio 1.95, 95% confidence interval 1.48-2.59). Factors associated with these symptoms were female sex, higher age at present, long duration of any CeD-related symptoms before diagnosis and presence of autoimmune thyroid diseases and osteoarthritis. CeD is associated with musculoskeletal symptoms even on a strict GFD. Possible susceptibility to current musculoskeletal complaints should be kept in mind, especially among certain risk patients such as those with long diagnostic delay and osteoarthritis.