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Bone metabolism in celiac disease.
Chiara Zanchi1, Grazia Di Leo, Luca Ronfani
1Department of Reproductive and Development Science, University of Trieste and Institute of Child Health IRCCS, Burlo Garofolo, Trieste, Italy.
The Journal of Pediatrics
|June 7, 2008
Summary
Children with celiac disease (CD) often have calcium metabolism issues and bone defects. A gluten-free diet (GFD) effectively normalizes these parameters, suggesting routine bone studies aren't needed for children on a GFD.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Metabolic Bone Disease
Background:
- Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
- CD can lead to malabsorption and nutrient deficiencies, impacting bone health.
- Altered calcium metabolism and bone defects are potential complications in pediatric CD.
Purpose of the Study:
- To determine the prevalence of calcium metabolism alterations and bone defects in children with celiac disease.
- To assess the impact of a gluten-free diet (GFD) on these parameters.
Main Methods:
- Studied 54 untreated children with CD and 60 healthy controls.
- Measured serum calcium, magnesium, 25(OH)vitamin D3, alkaline phosphatase, and parathyroid hormone (PTH).
- Performed DEXA scans on CD patients with laboratory abnormalities before and after 6 months of GFD.
Main Results:
- Children with CD showed lower calcium and 25(OH)vitamin D3 levels, and higher PTH levels compared to controls.
- Hyperparathyroidism was observed in 29% of CD patients; 10 were osteopenic.
- A 6-month GFD normalized calcium, 25(OH)vitamin D3, and PTH levels, improving bone mineral density.
Conclusions:
- Calcium metabolism defects are prevalent in untreated children with CD.
- These metabolic abnormalities resolve with a GFD.
- Extensive bone metabolism studies may not be necessary for children with CD adhering to a GFD.
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