Bone quantitative ultrasound and bone mineral density in children with celiac disease.
OBJECTIVE
Osteoporosis is the most common manifestation of untreated celiac disease (CD). Bone quantitative ultrasound (QUS) has recently emerged as a new modality for bone status assessment. We evaluated bone status in children with CD using dual-energy x-ray absorptiometry and quantitative ultrasound.


METHODS
This cross-sectional study included 41 children (13 girls, 28 boys) aged 11.2 +/- 3.6 years with CD. All children had been diagnosed with CD for at least 1 year (mean, 5.7 +/- 4.3 years). The results of lumbar spine bone mineral density assessed by dual-energy x-ray absorptiometry and the measurements of the velocity of ultrasound wave (at distal radius and midshaft tibia sites), expressed as speed of sound in m/s, were compared between children adherent to gluten-free diet (GFD) and non-compliant children.


RESULTS
Speed of sound z-scores at tibia were below -2 SD in 20 of 41 children (49%), whereas lumbar spine bone mineral density z-scores were below -2 SD in 4 of 41 (10%) children with CD (P = 0.0002). Only 19 of 41 children were strictly compliant to GFD. The prevalence of tibia speed of sound z-scores <-2 SD was significantly higher in non-compliant children (15 of 22, 68%) compared with children on GFD (5 of 19, 26%), (P = 0.01). Children non-compliant with GFD had significantly worse tibia speed of sound z-scores (-2.3 +/- 1.8, mean +/- SD) compared with children on GFD (-1.2 +/- 1.5, mean +/- SD) (P = 0.04).


CONCLUSIONS
Children with CD on a gluten-containing diet had higher prevalence of abnormal tibia bone SOS and lower z-scores compared with children on a GFD. These differences were not detected by spinal dual-energy x-ray absorptiometry or radius speed of sound. The value of quantitative ultrasound for screening and follow-up of children with CD should be further evaluated.
Hartman
Corina
C
Division of Pediatric Gastroenterology and Nutrition, Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel.
Hino
Bayan
B
Lerner
Aaron
A
Eshach-Adiv
Orly
O
Berkowitz
Drora
D
Shaoul
Ron
R
Pacht
Avi
A
Rozenthal
Eldad
E
Tamir
Ada
A
Shamaly
Hussein
H
Shamir
Raanan
R
D015502:Absorptiometry, Photon / Q000379:methods; D000293:Adolescent; D015519:Bone Density / Q000187:drug effects / Q000502:physiology; D016022:Case-Control Studies; D002446:Celiac Disease / Q000150:complications* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005983:Glutens / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000209:etiology; D010349:Patient Compliance; D011884:Radius / Q000000981:diagnostic imaging; D012680:Sensitivity and Specificity; D013977:Tibia / Q000000981:diagnostic imaging*; D014463:Ultrasonography
D005983:Glutens