Bone Mineral Density in Celiac Disease.

OBJECTIVES: To study bone mineral density (BMD) and standard serum biochemical indices among newly diagnosed and already diagnosed cases of Celiac Disease (CD) on gluten free diet for at least one year.

METHODS: This hospital based analytic, observational study was done at a tertiary care centre, from April 2013 through June 2014. Thirty six children (20 females) with untreated CD at diagnosis (Group A) and 36 age and sex matched children on gluten-free diet for at least one year (Group B) were studied. Serum measurements of biochemical bone health indices and BMD, assessed by dual X-ray absorptiometry, were obtained.

RESULTS: BMD Z-score was significantly low in newly diagnosed celiac patients. Patients on gluten free diet had higher BMD Z-score as compared to newly diagnosed patients (-2.02 vs. -0.65 respectively, p < 0.001). BMD Z-score was high in GI symptom patients as compared to non-GI symptom patients (-0.46+/-0.89 vs. - 0.88 = +/-0.94) in Group B. In female patients BMD Z-score was comparatively low as compared to male patients in both groups but difference was not significant. In Group A the mean serum calcium level was lower than the patients in Group B (8.72 + 0.73 vs. 9.34 + 0.65, p < 0.001). S. calcium levels were not correlated with bone mineral density (BMD) in both groups (P value >0.05).

CONCLUSIONS: Children with CD are at risk for reduced BMD. Strict gluten-free diet significantly improves bone mineralization. Early diagnosis and treatment of celiac disease during childhood may protect CD patients from osteoporosis.