[Compliance with gluten free diet, physical development and bone mineral status in patients with celiac disease]

The aim of the study was the assessment of the influence of a gluten free diet on physical development and bone mineral density (BMD) in patients with celiac disease.

59 patients (40 girls, 19 boys) aged 10-20 years with celiac disease, diagnosed according to ESPGAN criteria were included in the study. Patients were divided in 3 groups: 1--strict gluten free diet, II--not entirely compliant i.e. faults in gluten free diet 1-2 times per week, III--gluten free diet not followed or frequent faults. Daily calcium (Ca) intake and physical activity was assessed. BMD of the lumbar spine L2-L4 was measured by dual-energy-X-ray absorptiometry with LUNAR DPX-IQ. Physical development was assessed by anthropometric measurements: growth and weight.

Gluten free diet was strictly followed by 16 (27%) patients (group I), group II consisted of 23 (39%) patients. Diet was not followed by 20 (34%) patients. Thirty five (59%) patients had low Ca intake and they made up the majority of the patients in every group. High physical activity declared 35 (59%) patients. No statistically significant differences in BMD were found between group I and II. BMD was lower in group III in comparison to group I (p = 0.01) and group II (p = 0.003). BMD was higher in patients with high Ca intake (p = 0.002). Physical activity had no significant influence on BMD. There was no statistically significant difference in physical development between groups.

Majority of the patients with celiac disease did not strictly follow gluten free diet. Poor compliance to the diet had no significant influence on physical development. BMD was lower in patients who were not compliant to the gluten free diet, occasional faults in the diet had no influence on the BMD.