Bone density and bone metabolism are normal after long-term gluten-free diet in young celiac patients

Objectives: Osteoporosis and alterations of bone metabolism are frequent co mplications of celiac disease, We evaluated the impact of long-term gluten- free diet (GFD) initiated during childhood and adolescence on bone minerali zation and bone metabolism. Methods: We studied 30 celiac patients on GFD f or greater than or equal to 5 yr, The mean age at diagnosis was 11.4 +/- 5. 0 yr, and the mean duration of GFD was 10.7 +/- 4.3 yr, Results were compar ed with those obtained in 240 healthy controls. Bone mineral density (BMD) was measured in the lumbar spine and in the whole skeleton by dual-energy x -ray absorptiometry. Serum levels of bone-specific alkaline phosphatase (BA LP) and N-terminal propeptide of type I procollagen (PINP) were measured as bone formation indices, and urine levels of N-telopeptide of type I collag en (NTx) as bone resorption index, Results: BMD measurements of celiac pati ents (lumbar spine: 1.131 +/- 0.121 g/cm(2); total body: 1.145 +/- 0.184 g/ cm(2)) did not differ from those of control subjects (lumbar spine: 1.131 a 0.184 g/cm(2); total body: 1.159 +/- 0.118 g/cm(2)), The levels of BALP, P INP, and NTx of celiac patients did not differ from those of controls. Pati ents who started GFD before puberty had BMD and bone metabolism measurement s comparable to those of patients who started GFD during puberty. Conclusio ns: Our data show that long-term dietary treatment ensures normal mineraliz ation and bone turnover. (Am J Gastroenterol 1999;94:398-403. (C) 1999 by A m. Cell. of Gastroenterology).