A team from Samsun and Ankara, Turkey, investigated the prevalence of osteopenia among children with celiac disease.
They also examined the effect of a gluten-free diet on bone mineral density (BMD) in these subjects.
The study included 32 patients with celiac disease (Group 1) and 82 healthy controls (Group 2).
The patients with celiac disease were evaluated under 2 subgroups: 16 patients recently diagnosed (Group 1a) and 16 patients who followed their diet strictly (Group 1b).
BMD values and concentrations of calcium, phosphorus, alkaline phosphatase, and intact parathyroid hormone were determined on entry to the study and at 12 months in celiac patients.
These values were compared with those of healthy control participants.
BMD and bone mineral content values in patients with recent diagnosis were found to be significantly lower than the control group.
| Celiac patients with low BMD need to be followed-up for longer than a year.
| Pediatrics |
The BMD values in patients with recent diagnosis were significantly increased after a gluten-free diet for 1 year.
Osteopenia was found more commonly in patients with recent diagnosis than patients in whom a gluten-free diet had been instituted.
The researchers found that, at 1-year follow-up, osteopenia was not resolved with the gluten-free diet. This was especially true in patients without gastrointestinal manifestation.
In patients with recent diagnosis (Group 1a), the mean calcium level was found to be lower than the patients who follow their diet strictly (Group 1b).
There was a positive correlation between calcium level and BMD and bone mineral content.
Ayhan Gazi Kalayci, of the Ondokuz Mayis University, Samsun, said on behalf of colleagues, "BMD is almost invariably low in newly diagnosed celiac patients in childhood. We therefore recommend that BMD should be evaluated in patients with celiac disease."
"Strict gluten avoidance promoted a significant increase in BMD. However, values still remained markedly low after 1 year of follow-up in some patients.
"These patients should be followed for longer periods of time with yearly BMD evaluation, as 1 year of diet therapy was found to be insufficient for osteopenia to be resolved," it was concluded.