title: Bone quantitative ultrasound and bone mineral density in children with celiac disease.
abstract: 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.
authors.affiliation: Division of Pediatric Gastroenterology and Nutrition, Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel.
authors.forename: Corina
authors.initials: C
authors.lastname: Hartman
authors.forename: Bayan
authors.initials: B
authors.lastname: Hino
authors.forename: Aaron
authors.initials: A
authors.lastname: Lerner
authors.forename: Orly
authors.initials: O
authors.lastname: Eshach-Adiv
authors.forename: Drora
authors.initials: D
authors.lastname: Berkowitz
authors.forename: Ron
authors.initials: R
authors.lastname: Shaoul
authors.forename: Avi
authors.initials: A
authors.lastname: Pacht
authors.forename: Eldad
authors.initials: E
authors.lastname: Rozenthal
authors.forename: Ada
authors.initials: A
authors.lastname: Tamir
authors.forename: Hussein
authors.initials: H
authors.lastname: Shamaly
authors.forename: Raanan
authors.initials: R
authors.lastname: Shamir
mesh_terms: 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
chemical_list: D005983:Glutens