Bone mineral density and growth in children with coeliac disease on a gluten free-diet

Kırşaçlıoğlu, Ceyda Tuna; Kuloğlu, Zarife; Tanca, Aydan; Küçük, N.; Aycan, Zehra; Öçal, Gönül; Ensarı, Arzu; Kalaycı, Ayhan Gazi; Girgin, Nurten

doi:10.3906/sag-1508-52

Cited by 10 publications

(12 citation statements)

References 25 publications

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“…Children and adolescents with CD may present problems and difficulties in peaking bone mass achievement, as proposed by other authors [60]. In this same line, some authors suggest adding calcium and vitamin D supplementation to GFDs [66,67,68].…”

Section: Discussionmentioning

confidence: 91%

Nutritional Status in Spanish Children and Adolescents with Celiac Disease on a Gluten Free Diet Compared to Non-Celiac Disease Controls

et al. 2019

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Patients who follow a gluten-free diet (GFD) may be prone to nutritional deficiencies, due to food restriction and consumption of gluten-free products. The aim was to assess nutritional status in celiac children and adolescents on a long-term GFD. A cross-sectional age and gender-matched study in 70 celiac and 67 non-celiac volunteers was conducted, using dietary, anthropometric, biochemical parameters, and assessing bone mineral density and physical activity. Adequacy of vitamin D intake to recommendations was very low, in both groups, and intakes for calcium and magnesium were significantly lower in celiac volunteers. Celiac children and adolescents may have a higher risk of iron and folate deficiencies. Both groups followed a high-lipid, high-protein, low fiber diet. Median vitamin D plasma levels fell below reference values, in celiac and non-celiac participants, and were significantly lower in celiac girls. Other biochemical parameters were within normal ranges. Anthropometry and bone mineral density were similar within groups. With the exception of some slightly lower intakes, children and adolescents following a GFD appear to follow the same trends as healthy individuals on a normal diet. No effect of food restriction or gluten-free product consumption was observed.

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Section: Discussionmentioning

confidence: 91%

Nutritional Status in Spanish Children and Adolescents with Celiac Disease on a Gluten Free Diet Compared to Non-Celiac Disease Controls

et al. 2019

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“…Nonetheless, the available data on the effect of GFD on BMD provide discordant results, probably due to the different characteristics of the population studied in terms of age and sex, and due to the different amount of time on a GFD. Once the elimination of gluten occurs, the greatest gain in bone mass is established in the first year [ 24 ], and the GFD leads to a 5% increase in bone mass after one year of implementation [ 25 ]. However, in several studies [ 26 , 27 ], improvement in BMD after undertaking a GFD was only observed in patients who initially had secondary hyperparathyroidism, low serum calcium and vitamin D. Therefore, it may not be easy to normalize BMD in adults with CD [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Nutritional Status in Spanish Adults with Celiac Disease Following a Long-Term Gluten-Free Diet Is Similar to Non-Celiac

et al. 2021

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The only available treatment for celiac disease is life-long gluten exclusion. We conducted a cross-sectional age- and gender-matched study in 64 celiac adults on a long-term (>1 year) gluten-free diet and 74 non-celiac volunteers from Spain, using dietary, anthropometric, and biochemical parameters, as well as assessing bone mineral density and physical activity. Celiac adults had deficient intake (below 2/3 of the recommended intake) for folates, vitamin E, and iodine and low intake of calcium (below 80% of the recommended intake). Iron intake was also below 2/3 of the recommended intake in celiac women. Vitamin D intake was extremely low, and 34% of celiac patients had moderately deficient plasma levels. According to bone mineral density, celiac women may be more prone to osteopenia and osteoporosis. However, we found a perfectly analogous nutritional status scenario in celiac as compared to healthy volunteers, with the dietary deviations found being similar to those of the Spanish population, i.e., both groups followed a high-lipid, high-protein, and low-carbohydrate diet. Values for biochemical parameters were found within the reference ranges. Celiac disease had no influence on body weight, but body fat in celiac patients tended to be higher. According to our results, vitamin D, calcium, folates, vitamin E, iodine, and iron nutritional status should be specifically assessed and monitored in the celiac population.

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“…In the literature, it has been reported that BMD was found to be lower in those children with CD compared to healthy children ( 5 , 6 , 7 , 12 ).…”

Section: Discussionmentioning

confidence: 98%

“…In various studies, it has been reported that the rate of children with a BMD z-score CA <-2 SD was 10.8-16% at the time of diagnosis ( 11 , 12 ). Kalayci et al ( 4 ), in an earlier study on 16 pediatric patients diagnosed with CD, reported this rate to be much higher (50%).…”

Section: Discussionmentioning

confidence: 99%

“…In the literature, several factors including hypocalcemia due to malabsorption, vitamin D deficiency, secondary hyperparathyroidism, low physical activity due to fatigue, autoimmune factors, and inflammation have been suggested to be associated with low BMD. However, in most of these studies, the number of cases was limited and results were varied ( 4 , 8 , 9 , 10 , 11 , 12 ). In a recent retrospective cohort study, the only difference between the group with the BMD z-score of <-2 standard deviation (SD) and the rest of the cases was the low (<-0.4) standard deviation of the body mass index (BMI) ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated with Low Bone Mineral Density at the Time of Diagnosis in Children with Celiac Disease

Çamtosun¹,

Varol²,

Güngör³

et al. 2023

Jcrpe

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Objective: It has been reported that bone mineral density (BMD) is decreased in children with Celiac disease (CD) compared to their healthy peers. The aim of this study was to reveal possible risk factors for low BMD in Turkish children newly diagnosed with CD. Methods: Eighty-six patients (2-18 years old) with CD were included in this retrospective study. The relationship between their lumbar BMD z-scores calculated according to their chronological age (CA) and height age (HA) and their clinical, laboratory [biochemical parameters, tissue transglutaminase antibody-IgA (TTGA) levels, human leukocyte antigen (HLA) types] and histopathological parameters were evaluated. Results: The mean age of the patients at diagnosis was 8.06±4.08 years. The BMD z-score CA was ≤-2 standard deviation (SD) in 26.7% of the patients. The BMD z-score HA was ≤-2 SD in 12.8% of the patients. The BMD z-score HA only correlated with their age at diagnosis of CD (r s value 0.269). However, there was no statistically difference between the BMD z-score HA >-2 SD and ≤-2 SD subgroups regarding their clinical, laboratory and histopathological parameters. Conclusion: Low BMD is common in children with newly diagnosed CD. Age at diagnosis, gender, body size, Celiac symptoms, biochemical parameters, TTGA level, HLA type, and histopathological stage had no predictive values in terms of low BMD in this patient group.

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Bone mineral density and growth in children with coeliac disease on a gluten free-diet

Abstract: In CD, the first year of GFD is important in weight gain, linear growth, and improvement of BMD. A considerable relation of low BMD in children with CD, with respect to z-scores for CA, may be a result of misinterpretation of low BMD due to short stature.

Cited by 10 publications

References 25 publications

Nutritional Status in Spanish Children and Adolescents with Celiac Disease on a Gluten Free Diet Compared to Non-Celiac Disease Controls

Nutritional Status in Spanish Children and Adolescents with Celiac Disease on a Gluten Free Diet Compared to Non-Celiac Disease Controls

Nutritional Status in Spanish Adults with Celiac Disease Following a Long-Term Gluten-Free Diet Is Similar to Non-Celiac

Factors Associated with Low Bone Mineral Density at the Time of Diagnosis in Children with Celiac Disease

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