Gluten-free diet promotes BMD increase in children with celiac disease
מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Osteopenia is often found in children with untreated celiac disease, according to a report in the electronic edition of Pediatrics for November. While strict gluten avoidance helps promote an increase in bone mineral density (BMD), values may not be normal even after 1 year of treatment.
Dr. Ayhan Gazi Kalayci, of Ondokuz Mayia University, Samsun, Turkey, and colleagues assessed 32 children with celiac disease and 82 healthy control subjects. The patients were divided into two groups: 16 with a recent diagnosis (median duration of symptoms 3.2 years) and 16 who had followed a gluten-free diet strictly for 19 to 84 months (mean 40 months).
Patients with recently diagnosed celiac disease had significantly lower BMD and bone mineral content values than control subjects. The BMD values in these patients were significantly increased after 1 year on a gluten-free diet.
"Osteopenia was found more commonly in patients with recent diagnosis than patients in whom a gluten-free diet had been instituted," the investigators explain. "At 1 year follow-up, osteopenia was not resolved with the gluten-free diet, and this was especially true in patients without gastrointestinal manifestation."
Among recently diagnosed patients, the mean calcium level was lower in those who followed their diet strictly. The authors observed a positive correlation between serum calcium level and BMD in this group.
"Studies with considerable longer follow-up will be needed to determine whether remineralization continues and a complete restoration of bone mass can be achieved," Dr. Kalayci and colleagues note.
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