Bone mineral density (BMD) in children with celiac disease (CD): Its relation to puberty and calcium intake.

Bone mineral density (BMD) and calcium intake were studied in 39 celiac pat ients (CP) with good compliance for the gluten free diet in 39 healthy subj ects, aged 6 to 16 years of age (17 prepuberal and 22 puberal) in a case-co ntrol design (1;1). Nutritional and statural adequacy were evaluated by mea ns of the body mass index (BMI), and height for age (H/A) respectively, exp ressed as z score. BMD in the whole body, spine and hip was evaluated using a LUNAR densitometer in prepuberal and as puberalCD. Food intake was deter mined by 24 hours recall. Anti-endomisium and anti-gliadin antibodies and b one age were also evaluated. Statural adequacy of celiacs was significantly lower (p<0.000) than controls (-0.98+/-1.0 vs 0.19+/-0.93 respectively in prepuberal children) and (-1.0+/-1.2 vs -0.06+/-1.06 in puberal children) w ithout differences in BMI (0.08+/-0.93 vs 0.15+/-1.53 in prepuberal and 0.6 3+/-1.39 vs 1.25+/-1.17 in puberal subjects respectively). The bone age was similar to chronological age in CD. In 6 of 33 CD anti-gliadin and anti-en domisium antibodies were positive; the 6 patients were asymtomatic, with sa tisfactory dietary compliance and with blood xylose levels above 30 mg/dL. Puberal celiacs had lower calorie, protein and calcium intakes (1630+/-647 Kcal, 55+/-24 g and 686+/-289 mg respectively) than controls (217+/-619 Kca l, 82+/-23 g and 993+/-259 mg respectively). Prepuberal celiac patients had significantly lower BMD than controls only in the femoral neck (-0.3+/-0.8 0 vs 1.04+/-2.0 respectively). Puberal celiacs had significantly lower whol e body BMD (-0.34+/-0.72 vs 0.63+/-0.67 respectively) spine (-1.0+/-1.05 vs 0.48+/-1.21 respectively) and hip (-0.45+/-0.9 vs 0.42+/-1.03 respectively ) than controls. In puberal celiacs the t score, was significantly more neg ative than controls for the whole body (2.15+/-1.29 vs -0.68+/-1.25), spine (-3.17+/-1.88 vs 1.58+/-2.12) and hip (-0.81+/-0.67 vs -0.29+/-0.73 respec tively). The risk of a negative score was 2.7 times greater for the whole b ody and 8 times greater in the spine of celiac patients. We conclude that C P with a good compliance had lower stature and of BMD than puberal patients . CD patients had a calcium intake below 50% of recomendation. They constit ute a risk group of osteoporosis in future life. (C) 1999 Elsevier Science inc.