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Bone Mineral Density in Celiac Disease
Ganesh Choudhary1, Raj Kumar Gupta2, Jaiveer Beniwal3
1S.M.S. Medical College, Jaipur, India.
Insights
Children with celiac disease (CD) have reduced bone mineral density (BMD). A strict gluten-free diet significantly improves BMD, highlighting the importance of early diagnosis and treatment to prevent osteoporosis in pediatric CD patients.
Area of Science:
- Pediatric Endocrinology
- Gastroenterology
- Bone Metabolism
Background:
- Celiac disease (CD) is an autoimmune disorder triggered by gluten ingestion.
- CD can lead to malabsorption and nutritional deficiencies, impacting bone health.
- Children with CD are at risk for reduced bone mineral density (BMD).
Purpose of the Study:
- To compare BMD and serum biochemical indices in newly diagnosed CD patients versus those on a gluten-free diet (GFD) for at least one year.
- To assess the impact of a GFD on bone health in pediatric CD patients.
- To identify factors influencing BMD in children with CD.
Main Methods:
- An observational study involving 72 children with CD (36 untreated, 36 on GFD for ≥1 year).
- Bone mineral density (BMD) was assessed using dual-energy X-ray absorptiometry (DXA).
- Serum biochemical markers related to bone health were measured.
Main Results:
- Newly diagnosed CD patients exhibited significantly lower BMD Z-scores compared to those on a GFD (-2.02 vs. -0.65).
- Patients on a GFD showed higher BMD Z-scores, indicating improved bone mineralization.
- Lower serum calcium levels were observed in newly diagnosed CD patients compared to those on a GFD.
Conclusions:
- Children with celiac disease are susceptible to diminished bone mineral density.
- Adherence to a strict gluten-free diet is crucial for improving bone mineralization in CD patients.
- Early diagnosis and intervention in childhood celiac disease can mitigate the risk of osteoporosis.
Objectives:
To study bone mineral density (BMD) and standard serum biochemical indices among newly diagnosed and already diagnosed cases of Celiac Disease (CD) on gluten free diet for at least one year.
Methods:
This hospital based analytic, observational study was done at a tertiary care centre, from April 2013 through June 2014. Thirty six children (20 females) with untreated CD at diagnosis (Group A) and 36 age and sex matched children on gluten-free diet for at least one year (Group B) were studied. Serum measurements of biochemical bone health indices and BMD, assessed by dual X-ray absorptiometry, were obtained.
Results:
BMD Z-score was significantly low in newly diagnosed celiac patients. Patients on gluten free diet had higher BMD Z-score as compared to newly diagnosed patients (-2.02 vs. -0.65 respectively, p < 0.001). BMD Z-score was high in GI symptom patients as compared to non-GI symptom patients (-0.46+/-0.89 vs. - 0.88 = +/-0.94) in Group B. In female patients BMD Z-score was comparatively low as compared to male patients in both groups but difference was not significant. In Group A the mean serum calcium level was lower than the patients in Group B (8.72 + 0.73 vs. 9.34 + 0.65, p < 0.001). S. calcium levels were not correlated with bone mineral density (BMD) in both groups (P value >0.05).
Conclusions:
Children with CD are at risk for reduced BMD. Strict gluten-free diet significantly improves bone mineralization. Early diagnosis and treatment of celiac disease during childhood may protect CD patients from osteoporosis.
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