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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 patients (CP) with good compliance for the gluten free diet in 39 healthy subjects, aged 6 to 16 years of age (17 prepuberal and 22 puberal) in a case-control design (1;1). Nutritional and statural adequacy were evaluated by means of the body mass index (BMI), and height for age (H/A) respectively, expressed as z score. BMD in the whole body, spine and hip was evaluated using a LUNAR densitometer in prepuberal and as puberal CD. Food intake was determined by 24 hours recall. Antiendomisium and anti-gliadin antibodies and bone 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) without differences in BMI (0.08±0.93 vs 0.15±1.53 in prepuberal and 0.63±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-endomisium antibodies were positive; the 6 patients were asymtomatic, with satisfactory 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 (2179±619 Kcal, 82±23 g and 993±259 mg respectively). Prepuberal celiac patients had significantly lower BMD than controls only in the femoral neck (−0.32±0.80 vs 1.04±2.0 respectively). Puberal celiacs had significantly lower whole 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 negative 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 respectively). The risk of a negative score was 2.7 times greater for the whole body and 8 times greater in the spine of celiac patients. We conclude that CP with a good compliance had lower stature and of BMD than puberal patients. CD patients had a calcium intake below 50% of recomendation. They constitute a risk group of osteoporosis in future life. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Nutrition Research Elsevier
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