Bone mineral density in children with celiac disease. Effect of a Gluten-free diet.
OBJECTIVE
To assess the degree of osteopenia in children with celiac disease (CD) at the time of diagnosis and the effect of a gluten-free diet (GFD).


METHODS
Longitudinal and prospective study.


METHODS
In total, 24 children (18 girls, six boys) diagnosed with CD by means of an intestinal biopsy were included in the study. Mean+/-s.d. age was 4.9+/-4.3 years. In all, 16 patients were under (2.20+/-0.82 year) and eight were over the age of 4 years (10.30+/-2.90 year). The time between the first symptoms and diagnosis was 17.30+/-24.70 months (range: 2-109 months). Spine bone mineral content (BMC), area and bone mineral density (BMD) were measured by DXA at baseline and 1.17+/-0.93 years after GFD.


RESULTS
Before treatment, mean+/-s.d. BMD was 0.46+/-0.13 g/cm(2), the BMD Z-score was -1.36+/-1.20, and was below -1 s.d. in 14 patients (58%). BMC, area and BMD increased significantly on GFD. BMD increased from 0.46+/-0.13 to 0.55+/-0.13 g/cm(2) (P<0.001). BMD Z-score improved from -1.36+/-1.20 to -0.23+/-1.20 after GFD. However, BMD increased more than 1 s.d. in 15 of the 16 children under the age of 4 years, a similar increase was only observed in four of the eight children aged more than 4 years, some of whom did not follow GFD strictly. Height and weight increased significantly with GFD (P<0.001) and the increase correlated positively with the increase in BMD.


CONCLUSIONS
Axial BMD below -1 s.d. was found in 58% of children with celiac disease. Axial bone mass reverted to normal values in most children under the age of 4, who had low bone mass, all of whom followed GFD strictly.
Tau
C
C
Metabolismo Cálcico y Oseo, Endocrinología, Hospital de Pediatría J.P. Garrahan, Buenos Aires, Argentina. cristinatau@uol.com.ar
Mautalen
C
C
De Rosa
S
S
Roca
A
A
Valenzuela
X
X
D015502:Absorptiometry, Photon / Q000379:methods; D000293:Adolescent; D001827:Body Height / Q000502:physiology; D001835:Body Weight / Q000502:physiology; D015519:Bone Density / Q000187:drug effects* / Q000502:physiology; D002446:Celiac Disease / Q000178:diet therapy* / Q000378:metabolism* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005983:Glutens / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies
D005983:Glutens