title: Slight decrease in bone mineralization in cow milk-sensitive children.
abstract: BACKGROUND
  Patients with cow milk allergy (CMA) are potentially at risk for osteopenia because their milk-free diet usually contains a low calcium content. In our study, different parameters of bone mineralization in children with CMA were investigated.
  
  
  METHODS
  Twenty-seven CMA patients (mean age, 4.3 years; range, 3-8 years) were enrolled in the study. During a mean milk-free diet period of 11.8 months, children were fed extensively hydrolyzed or soy-based formulas. After a milk challenge test, 7 patients showed allergic symptoms, and the other 20 children had transient CMA. From the sera of all patients, the levels of sodium, potassium, chloride, calcium, phosphate, and magnesium ions, as well as alkaline phosphatase (AP), parathyroid hormone (PTH), osteocalcin, and beta-crosslaps, were determined. These values were compared with those of 20 healthy age-matched controls. Bone mineral density was measured as well.
  
  
  RESULTS
  The AP and PTH concentrations were higher in CMA patients than in the control group (AP: 610.2 U/L vs. 499.7 U/L, P < 0.01; PTH: 1.56 pmol/L vs. 0.83 pmol/L, P< 0.03), but all values were in the normal range. The osteocalcin concentration was similar in both groups, and the beta-crosslaps concentration was lower in CMA patients than in controls (0.92 vs. 1.47 ng/mL, P< 0.001). The mean Z score of bone mineral density in patients with CMA was -0.6. In 10 cases, the Z score was less than the -1 SD value. On the basis of the Z score, CMA patients were divided into two groups. The PTH concentration was significantly elevated in the group with lower Z score (2.24 pmol/L vs. 1.16 pmol/L; P< 0.03).
  
  
  CONCLUSIONS
  The results suggest that, in children with CMA who are on a cow milk-free diet, slight disturbances of bone mineralization can be observed by osteodensitometry.
authors.affiliation: First Department of Pediatrics, Semmelweis University, Faculty of Medicine, Budapest, Hungary. hedit@gyer1.sote.hu
authors.forename: Edit
authors.initials: E
authors.lastname: Hidvégi
authors.forename: András
authors.initials: A
authors.lastname: Arató
authors.forename: Endre
authors.initials: E
authors.lastname: Cserháti
authors.forename: Csaba
authors.initials: C
authors.lastname: Horváth
authors.forename: András
authors.initials: A
authors.lastname: Szabó
authors.forename: Antal
authors.initials: A
authors.lastname: Szabó
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D000818:Animals; D015519:Bone Density / Q000502:physiology; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000209:etiology*; D002113:Calcification, Physiologic / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008892:Milk / Q000009:adverse effects*; D016269:Milk Hypersensitivity / Q000097:blood / Q000150:complications*; D015675:Osteocalcin / Q000097:blood
chemical_list: D015675:Osteocalcin; D000469:Alkaline Phosphatase