EFFECT OF GLUTEN-FREE DIET ON BONE-MINERAL METABOLISM OF CELIAC CHILDREN

Studies on the effects of gluten-free diet (GFD) on bone mineral metab olism have given no univocal results in children and adults with celia c disease. Bone mineral metabolism was assessed in 23 celiac children, aged 1 to 12 years (mean 4.6) at moment of diagnosis (T-0) and after 12 months of GFD (T-12) without any vitamin D supplementation. At T-0, calcium, phosphates and alkaline phosphatase values were within the n ormal range in all but few subjects, but their respective average valu es significantly rose at T-12. The percentages of low values of bone m ineral density and of osteocalcin at T-0 were significantly higher tha n those at T-12 and their respective average values significantly incr eased between T-0 and T-12 Circulating parathyroid hormone values were within the normal range in all patients at T-0 and T-12, with no sign ificant difference in average values between T-0 and T-12. One year of GFD is sufficient-to obtain a complete restoration of bone mineral de nsity even without vitamin D supplementation. The normal levels of par athyroid hormone and the reduced osteocalcin at diagnosis suggest that in young celiac children there is no important rise in bone remodelin g. (C) 1998 Elsevier Science Inc.