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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
PubMed

Insights

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.
Abstract

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