Choudhary Ganesh, Gupta Raj Kumar, Beniwal Jaiveer
S.M.S. Medical College, Jaipur, India.
Department of Pediatric Medicine, Sir Padampat Mother & Child Health Institute, SMS Medical College, Jaipur, Rajasthan, 302004, India.
Indian J Pediatr. 2017 May;84(5):344-348. doi: 10.1007/s12098-016-2273-1. Epub 2016 Dec 27.
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.
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.
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).
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.
研究新诊断的和已诊断的乳糜泻（CD）患者在至少一年的无麸质饮食后骨矿物质密度（BMD）和标准血清生化指标。
本基于医院的分析性观察研究于2013年4月至2014年6月在一家三级医疗中心进行。研究了36名诊断时未经治疗的CD儿童（20名女性，A组）和36名年龄、性别匹配且进行了至少一年无麸质饮食的儿童（B组）。通过双能X线吸收法评估获得了血清生化骨健康指标和BMD的测量值。
新诊断的乳糜泻患者BMD Z评分显著较低。与新诊断的患者相比，接受无麸质饮食的患者BMD Z评分更高（分别为-2.02和-0.65，p<0.001）。B组中，有胃肠道症状的患者BMD Z评分高于无胃肠道症状的患者（-0.46±0.89 vs -0.88±0.94）。在两组中，女性患者的BMD Z评分均低于男性患者，但差异不显著。A组的平均血清钙水平低于B组患者（8.72 + 0.73 vs 9.34 + 0.65，p<0.001）。两组中血清钙水平均与骨矿物质密度（BMD）无关（P值>0.05）。
CD患儿存在骨密度降低的风险。严格的无麸质饮食可显著改善骨矿化。儿童期乳糜泻的早期诊断和治疗可能使CD患者免受骨质疏松症的影响。
