Bone Mineral Density of the Lumbar Spine in Children and Adolescents With Celiac Disease on a Gluten‐Free Diet in São Paulo, Brazil

• Published in: Journal of pediatric gastroenterology and nutrition Vol. 37; no. 5; pp. 571 - 576
• Main Authors: Sdepanian, Vera Lucia, Miranda Carvalho, Cecília Noronha, Morais, Mauro Batista, Colugnati, Fernando Antonio Basile, Fagundes‐Neto, Ulysses
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins, Inc 01.11.2003; Lippincott
• Subjects: Adolescent; Adolescents; Biological and medical sciences; Body Height; Body Mass Index; Body Weight; Bone Density; Bone mineral density; Brazil; Calcium, Dietary - administration & dosage; Celiac disease; Celiac Disease - diet therapy; Celiac Disease - physiopathology; Child; Children; Diet; Gastroenterology. Liver. Pancreas. Abdomen; Glutens - administration & dosage; Gluten‐free diet; Humans; Lumbar Vertebrae; Magnesium - administration & dosage; Medical sciences; Nutritional status; Other diseases. Semiology; Phosphorus, Dietary - administration & dosage; Regression Analysis; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tropical medicine; South America; Brazil; America; Human; Immunopathology; Deficient diet; Nutrition; Lumbar spine; Diseases of the osteoarticular system; Coeliac disease; Statistical study; Treatment; Intestinal malabsorption; Celiac disease-Bone mineral density-Gluten-free diet-Nutritional status-Children-Adolescents; Digestive diseases; Intestinal disease; Bone mineral density; Child; Gluten; Quantitative analysis
• ISSN: 0277-2116; 1536-4801
• DOI: 10.1002/j.1536-4801.2003.tb12065.x

ABSTRACT Background To compare bone mineral density (BMD) in children and adolescents with celiac disease (CD) and control subjects and to evaluate diet adequacy and calcium metabolism in patients with CD. Methods Thirty patients with asymptomatic CD (17 children, 13 adolescents), on a gluten‐free diet, and 23 healthy subjects were studied. BMD of the lumbar spine (dual energy x‐ray absorptiometry) was performed on all patients and control subjects. In patients, food diaries for nine nonconsecutive days were obtained and analyzed. In patients, laboratory tests pertaining to calcium balance were obtained. Results The mean weight and height of the adolescents with CD were lower than those of control subjects (weight: 45.8 ± 10.5 kg v 55.3 ± 10.5 kg, P = 0.037; height: 153.0 ± 11.0 cm v 167 ± 12.0 cm, P = 0.007). The mean BMD in adolescents with CD was significantly lower than that of the control subjects (0.917 ± 0.116 g/cm2v 1.060 ± 0.158 g/cm2, P = 0.015), whereas no significant difference was found between children with CD and control subjects (P = 0.595). A multiple‐regression model shows that increases in BMD relative to height were lower in adolescents with CD than in control subjects. The proportion of adolescents who had started a gluten‐free diet after 2 years of age was higher than that of children with CD (P < 0.001). High percentages of magnesium, calcium, and phosphorous deficiencies were present in CD patients' diets. The serum levels of ionized and total calcium and parathormone were normal. Conclusions The BMD of adolescents with CD was lower than that of the control subjects, whereas no difference was found between the BMD of children with CD and that of control subjects.