Zanchi Chiara, Di Leo Grazia, Ronfani Luca, Martelossi Stefano, Not Tarcisio, Ventura Alessandro
Department of Reproductive and Development Science, University of Trieste and Institute of Child Health IRCCS, Burlo Garofolo, Trieste, Italy.
J Pediatr. 2008 Aug;153(2):262-5. doi: 10.1016/j.jpeds.2008.03.003. Epub 2008 Apr 14.
To investigate the prevalence of both calcium metabolism alterations and bone defects in children with celiac disease (CD).
We studied 54 untreated patients with CD (mean age, 7 years). We compared the serum concentration of calcium, magnesium, 25(OH)vitamin D3, alkaline phosphatase, and parathyroid hormone (PTH) of patients with CD with those of 60 healthy children. Children with CD with 2 laboratory alterations underwent DEXA examination, which was evaluated after 6 months of a gluten-free diet (GFD).
The calcium and the 25(OH)vitamin D3 levels were lower in children with CD than in control subjects, and the PTH level was higher in children with CD than in control subjects (P < .001). Hyperparathyroidism was found in 29 children with CD. Twenty patients tested positive for 2 laboratory alterations, and 10 of them were osteopenic. After 6 months of GFD calcium, 25(OH)vit.D3 and PTH levels normalized, with the improvement of bone mineral density.
Calcium metabolism defects are common in untreated children with CD, and they returned to normal after GFD. A detailed, time-consuming, and expensive study of bone metabolism is not necessary in children with CD shortly exposed to gluten who follow the GFD.
研究乳糜泻（CD）患儿钙代谢改变和骨缺陷的患病率。
我们研究了54例未经治疗的CD患儿（平均年龄7岁）。我们将CD患儿的血清钙、镁、25(OH)维生素D3、碱性磷酸酶和甲状旁腺激素（PTH）浓度与60名健康儿童的进行比较。有两项实验室指标改变的CD患儿接受了双能X线吸收法（DEXA）检查，在无麸质饮食（GFD）6个月后进行评估。
CD患儿的钙和25(OH)维生素D3水平低于对照组，CD患儿的PTH水平高于对照组（P <.001）。29例CD患儿发现甲状旁腺功能亢进。20例患儿两项实验室指标检查呈阳性，其中10例为骨质减少。GFD饮食6个月后，钙、25(OH)维生素D3和PTH水平恢复正常，骨密度得到改善。
钙代谢缺陷在未经治疗的CD患儿中很常见，在GFD饮食后恢复正常。对于短期接触麸质后遵循GFD饮食的CD患儿，无需进行详细、耗时且昂贵的骨代谢研究。
