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J Pediatr Gastroenterol Nutr. 2012 May;54(5):680-4. doi: 10.1097/MPG.0b013e31823f5fc5.

Bone health in children with celiac disease assessed by dual x-ray absorptiometry: effect of gluten-free diet and predictive value of serum biochemical indices.

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  • 1First Department of Paediatrics, University of Athens, Aghia Sophia Children's Hospital, Athens, Greece.

Abstract

OBJECTIVES:

In the present study, we aimed to assess bone status and the effect of gluten-free diet (GFD) in children with celiac disease (CD), and to evaluate the predictive value of standard serum biochemical indices in the diagnosis of bone mineral density (BMD) disturbances.

METHODS:

Forty-five children at the time of diagnosis of CD (group A, 77.8% girls) and 36 children receiving GFD for >2 years (group B, 75% girls) were included. Sixteen children in group A were reexamined 12 months after initiation of GFD. Serum measurements of biochemical bone health indices and BMD, assessed by dual x-ray absorptiometry, were obtained.

RESULTS:

Patients after 1 year of receiving GFD had higher BMD z scores compared with baseline (-1.45 ± 0.28 vs -0.61 ± 0.25, respectively, P = 0.004). BMD z scores were significantly lower than expected for the normal population, after 1 (P = 0.03) or at least 2 (P < 0.001) years of receiving GFD. In group B, BMD z score was positively correlated with 25-hydroxy vitamin D levels (P = 0.009). In the repeated measurements group, 25-hydroxy vitamin D differed between pre- and post-GFD (P = 0.018). No biochemical index was capable of predicting an abnormal BMD z score (receiver operating characteristic curve analysis, all of the areas under the curve <0.66).

CONCLUSIONS:

GFD has a beneficial effect on bone health. Two years receiving diet do not ensure normalization. Biochemical markers are not indicative of BMD disturbances. Dual x-ray absorptiometry should be included in the standard management of children with CD.

PMID:
22094895
DOI:
10.1097/MPG.0b013e31823f5fc5
[PubMed - indexed for MEDLINE]
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