Motta Maria Eugênia Farias Almeida, Faria Maria Eduarda Nóbrega de, Silva Gisélia Alves Pontes da
Division of Pediatric Gastroenterology, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
Sao Paulo Med J. 2009 Sep;127(5):278-82. doi: 10.1590/s1516-31802009000500006.
Low bone mineral density may be a finding among children and adolescents with celiac disease, including those undergoing treatment with a gluten-free diet, but the data are contradictory. The aim of this study was to determine the frequency of bone mineral density abnormalities in patients on a gluten-free diet, considering age at diagnosis and duration of dietary treatment.
Cross-sectional prevalence study at the Pediatric Gastroenterology Outpatient Clinic of Instituto Materno Infantil Professor Fernando Figueira.
Thirty-one patients over five years of age with celiac disease and on a gluten-free diet were enrolled. Bone mineral density (in g/cm(2)) was measured in the lumbar spine and whole body using bone densitometry and categorized using the criteria of the International Society for Clinical Densitometry, i.e. low bone mineral density for chronological age < -2.0 Z-scores. Age at diagnosis and duration of dietary treatment were confirmed according to the date of starting the gluten-free diet.
Low bone density for chronological age was present in 3/31 patients in the lumbar spine and 1/31 in the whole body (also with lumbar spine abnormality). At diagnosis, three patients with low bone mineral density for the chronological age were more than 7.6 years old. These patients had been on a gluten-free diet for six and seven months and 3.4 years.
Pediatric patients with celiac disease on long-term treatment are at risk of low bone mineral density. Early diagnosis and long periods of gluten-free diet are directly implicated in bone density normalization.
低骨矿物质密度可能是乳糜泻儿童和青少年中的一个发现，包括那些采用无麸质饮食治疗的患者，但数据存在矛盾。本研究的目的是确定采用无麸质饮食的患者中骨矿物质密度异常的频率，同时考虑诊断时的年龄和饮食治疗的持续时间。
在费尔南多·菲盖拉妇幼研究所儿科胃肠病门诊进行的横断面患病率研究。
纳入31名5岁以上患有乳糜泻且采用无麸质饮食的患者。使用骨密度测定法测量腰椎和全身的骨矿物质密度（单位：g/cm²），并根据国际临床骨密度测量学会的标准进行分类，即按实际年龄计算的低骨矿物质密度＜-2.0 Z值。根据开始无麸质饮食的日期确认诊断时的年龄和饮食治疗的持续时间。
按实际年龄计算，31名患者中有3名腰椎骨密度低，1名全身骨密度低（同时伴有腰椎异常）。在诊断时，3名按实际年龄计算骨矿物质密度低的患者年龄超过7.6岁。这些患者已进行无麸质饮食6个月、7个月和3.4年。
长期接受治疗的乳糜泻儿科患者存在低骨矿物质密度的风险。早期诊断和长期无麸质饮食与骨密度正常化直接相关。
