Significant improvement in bone mineral density in pediatric celiac disease: even at six months with gluten-free diet

Gerenli, Nelgin; Dursun, Fatma; Çeltik, Coşkun; Kırmızıbekmez, Heves

doi:10.1515/jpem-2020-0292

Cited by 6 publications

(4 citation statements)

References 36 publications

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“…Children and young adults with newly diagnosed CD benefit from vitamin D and calcium supplementation to improve their bone mineral density in a short period of six months with a strict gluten-free diet [ 58 , 59 ]. There is a paucity of studies that investigate the association between vitamin D supplementation and prevention of CD.…”

Section: Discussionmentioning

confidence: 99%

Differences in Plasma 25-Hydroxyvitamin D Levels at Diagnosis of Celiac Disease and Type 1 Diabetes

Marino,

Galeazzi,

Gesuita

et al. 2024

Nutrients

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Aim: The aim of this work is to assess the vitamin D levels, evaluated as plasma 25-hydroxyvitamin D of children with a new diagnosis of celiac disease (CD), of children with a new onset of type 1 diabetes (T1D) and in children with CD at diagnosis of T1D (T1D&CD). Methods: In this single-center observational study, we collected data for four groups of children and adolescents: T1D, CD, T1D&CD, and a control group (CG). The CG included schoolchildren who had negative results during a mass screening campaign for CD and were not diagnosed for T1D, according to RIDI Marche registry data, were considered for the purposes of this study. Plasma 25-hydroxyvitamin D, 25(OH)D2, and 25(OH)D3 were considered as the parameters for evaluating vitamin D nutritional status, and the date of measurement was recorded to analyze vitamin D level seasonality. Vitamin D nutritional status was categorized as follows: severe deficiency (<10 ng/mL), deficiency (<20 ng/mL), insufficiency (20–29 ng/mL), or sufficiency/adequacy (≥30 ng/mL). The Kruskal–Wallis test was used to compare the groups. The association of 25(OH)D levels with health conditions and seasonal differences of 25(OH)D levels was analyzed using a multiple linear regression model. Results: The number of children enrolled for the present study was 393: 131 in the CG, 131 CD, 109 T1D, and 22 T1D&CD. Significantly lower levels of vitamin D were displayed for children with CD, T1D, or both the diseases. Interestingly, severe vitamin D deficiency was detected in no children with CD, 1.5% of children in the CG, in 24.4% with T1D, and 31.8% with T1D&CD (p < 0.001). As expected, the CG children vitamin D levels were significantly influenced by seasonality. Contrarily, no seasonal differences were reported in children with CD, T1D, and T1D&CD. Multiple regression analysis showed that children with T1D and T1D&CD had lower 25(OH)D levels of 9.9 ng/mL (95% CI: 5.4; 14.5) and 14.4 ng/mL (95% CI: 6.2–22.7) compared to CG children (p < 0.001). Conclusions: Our results showed low levels of vitamin D diagnosis of T1D, CD, and T1D&CD; however, severe deficiency was only reported in children with T1D and T1D&CD. More studies are needed to better understand the role of this deficiency in children newly diagnosed with CD and T1D.

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Section: Discussionmentioning

confidence: 99%

Differences in Plasma 25-Hydroxyvitamin D Levels at Diagnosis of Celiac Disease and Type 1 Diabetes

Marino,

Galeazzi,

Gesuita

et al. 2024

Nutrients

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“…The patients and healthy controls were adjusted regarding the age. Osteoporosis was defined as a Z-score <−2, and if the Z-score was between −1 and −2, osteopenia was diagnosed [ 12 ].…”

Section: Methodsmentioning

confidence: 99%

Investigation of the Factors Affecting Bone Mineral Density in Children with Celiac Disease

Dehghani

Ilkhanipoor

Samipour

et al. 2022

Pediatr Gastroenterol Hepatol Nutr

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Purpose Children with celiac disease (CD) are at an increased risk of low bone mineral density (BMD) owing to malabsorption of fat-soluble vitamins, inflammation, and malnutrition. This study aimed to determine the prevalence and risk factors for low BMD in Iranian children with CD. Methods This prospective cohort study examined 149 Iranian children with CD between 2011 and 2018 at Zabol University of Medical Sciences. BMD was measured using dual-energy X-ray absorptiometry. Demographic, clinical, and laboratory data were collected from patients ’ medical records. Logistic regression analysis was performed to identify the factors associated with low areal BMD (BMD-Z <−2) in the lumbar spine and femoral neck. Descriptive data were analyzed using the mean, standard deviation, and relative frequency. Data were analyzed using the chi-square test, t -test, and analysis of variance. Results Of the 149 children with CD, 27.5% had osteoporosis. The mean body mass index (BMI) Z score was −1.28±1.2. Lower BMI was associated with a higher likelihood of BMD-Z (odds ratio 2.17; p ≤0.05). Conclusion Overall, the findings of this study showed that there was no correlation among Marsh classification, presence of specific human leukocyte antigens, and low BMD in Iranian children with CD. BMI can be a predictor of bone density in children with CD and may be applied clinically in early screenings to evaluate the bone health status in these children.

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“…Therefore, the importance of bone loss prevention, through an active search for bone derangement in all patients suffering from conditions responsible for a secondary osteoporosis, is evident. In CD patients diagnosed during childhood, a strict GFD from childhood normalizes BMD [ 9 ], and a significant bone mass gain could be evident, even after a six-month period of GFD [ 10 ]. Unfortunately, this is not the same in CD patients diagnosed in adulthood [ 7 ], making the adoption of strategies aimed at the prevention of osteoporosis very important.…”

Section: Bone and Mineral Metabolism In CD Patients At Diagnosis And ...mentioning

confidence: 99%

“…High levels of 1,25-vitamin D at diagnosis are frequently associated with high levels of PTH [ 4 , 14 ], and a strict GFD generally normalizes these alterations [ 4 , 14 , 15 , 16 , 17 ]. GFD-related improvement of PTH levels seem strictly related to the reversal of mucosal lesions, as hyperparathyroidism persists both in patients with refractory CD [ 10 ] and patients with a low compliance to GFD [ 18 ], and is associated with alterations of vitamin D metabolite levels [ 16 ]. However, one year of GFD duration is not always sufficient to normalize PTH levels [ 18 ], while a longer period was clearly shown to be effective [ 4 , 14 , 15 , 16 , 19 ].…”

Section: Bone and Mineral Metabolism In CD Patients At Diagnosis And ...mentioning

confidence: 99%

The Effect of a Gluten-Free Diet on Vitamin D Metabolism in Celiac Disease: The State of the Art

Miceli

Mengoli

et al. 2023

Metabolites

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Celiac disease is a chronic autoimmune disorder involving the small intestine, characterized by villous atrophy, crypt hyperplasia and an increase in intraepithelial lymphocytes. Due to both calcium malabsorption and immune activation, a high prevalence of bone mass derangement is evident in this condition, regardless of the presence of overt malabsorption. Alterations of mineral metabolism are also frequently described, and in this review, the modifications of serum levels of vitamin D are analyzed, according to the available literature on this topic. In untreated patients, secondary hyperparathyroidism is responsible for the hyperconversion of 25-vitamin D into 1,25-vitamin D making mandatory the determination of serum levels of both vitamin metabolites to avoid a wrong diagnosis of vitamin D deficit. A gluten-free diet allows for a normalization of bone and mineral metabolism, reverting these abnormalities and raising some doubts on the need for vitamin supplementation in all the patients. Data available do not support this wide indication, and a complete evaluation of bone and mineral metabolism should be performed to select patients who need this therapeutic approach.

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Significant improvement in bone mineral density in pediatric celiac disease: even at six months with gluten-free diet

Cited by 6 publications

References 36 publications

Differences in Plasma 25-Hydroxyvitamin D Levels at Diagnosis of Celiac Disease and Type 1 Diabetes

Differences in Plasma 25-Hydroxyvitamin D Levels at Diagnosis of Celiac Disease and Type 1 Diabetes

Investigation of the Factors Affecting Bone Mineral Density in Children with Celiac Disease

The Effect of a Gluten-Free Diet on Vitamin D Metabolism in Celiac Disease: The State of the Art

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