title: Lack of clinical predictors for low mineral density in children with celiac disease.
abstract: OBJECTIVE
  Metabolic bone disease remains a significant and common complication of celiac disease (CD). Several studies have demonstrated low bone mineral density (BMD) at the time of CD diagnosis in both children and adults. Low BMD in children and adolescents is defined as an areal BMD <2 SD below the age-adjusted mean value (z score <-2 SD). The aim of the study was to evaluate the BMD in a pediatric population with CD at diagnosis and to correlate z score value, anti-tissue transglutaminase type 2 antibody (anti-tTG2) titer, symptoms, and Marsh-Oberhuber (MO) grading.
  
  
  METHODS
  We enrolled 99 patients with celiac disease (male 35, female 64) ages 4 to 15 years at the diagnosis. All of the patients had positive test results for anti-tTG2 antibodies and histological lesions graded according to MO classification, and underwent lumbar dual-energy x-ray absorptiometry. BMD was estimated by z score.
  
  
  RESULTS
  Low BMD (z score ≤-2 SD) was found in 13 (13.13%) patients; 22 (22.22%) patients with CD showed -2 < z score ≤ -1; -1 < z score < 0 was found in 41 (41.41%) patients. z score ≥ 0 was detected only in 23 (23.23%) patients with CD. Mean BMD value in patients with CD is z score -0.68. No correlations were found between z score value and anti-tTG2 titer (Spearman ρ 0.13), between z score value and MO degree (Spearman ρ -0.17), and between z score and symptoms (Spearman ρ-0.10).
  
  
  CONCLUSIONS
  BMD of patients with CD at diagnosis does not seem to correlate with MO degree, anti-tTG2 titer, and symptoms. At the moment, we do not have clinical predictors for low mineral density in children with CD.
authors.affiliation: *Department of Pediatric Gastroenterology and Liver Unit, Department of Pediatrics †Department of Radiology, La Sapienza University of Rome, Rome, Italy.
authors.forename: Chiara M
authors.initials: CM
authors.lastname: Trovato
authors.forename: Carlina V
authors.initials: CV
authors.lastname: Albanese
authors.forename: Stefania
authors.initials: S
authors.lastname: Leoni
authors.forename: Ilaria
authors.initials: I
authors.lastname: Celletti
authors.forename: Francesco
authors.initials: F
authors.lastname: Valitutti
authors.forename: Costanza
authors.initials: C
authors.lastname: Cavallini
authors.forename: Monica
authors.initials: M
authors.lastname: Montuori
authors.forename: Maria
authors.initials: M
authors.lastname: Barbato
authors.forename: Carlo
authors.initials: C
authors.lastname: Catalano
authors.forename: Salvatore
authors.initials: S
authors.lastname: Cucchiara
mesh_terms: D000293:Adolescent; D001323:Autoantibodies / Q000032:analysis; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000150:complications; D002446:Celiac Disease / Q000150:complications* / Q000276:immunology / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D019204:GTP-Binding Proteins; D006801:Humans; D007070:Immunoglobulin A / Q000032:analysis; D008297:Male; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D012189:Retrospective Studies; D011503:Transglutaminases / Q000276:immunology
chemical_list: D001323:Autoantibodies; D007070:Immunoglobulin A; D000091345:Protein Glutamine gamma Glutamyltransferase 2; D011503:Transglutaminases; D019204:GTP-Binding Proteins