Department of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Ankara University, Ankara, Turkey.
Department of Nuclear Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey.
Turk J Med Sci. 2016 Dec 20;46(6):1816-1821. doi: 10.3906/sag-1508-52.
BACKGROUND/AIM: To evaluate changes in growth and bone metabolism during consumption of a gluten-free diet (GFD) in children with coeliac disease (CD).
Thirty-seven children with CD (mean age of 8.8 ± 4.6 years, 21 girls) were enrolled. Anthropometric measurements, bone mineral density (BMD) in lumbar 2-4 vertebrae, and serum alkaline phosphatase, calcium, and phosphorus levels at diagnosis and at follow-up were recorded.
The mean follow-up period was 3.5 ± 2.3 years. The BMD of patients was significantly lower than that of control subjects at the time of diagnosis but not after 1 year of the GFD. Incidence of low BMD with respect to z-scores for chronological age (CA) was significantly higher than z-scores for height age (HA) (P = 0.006). At the first year of GFD, BMD, BMD z-score, height-for-age z-scores, and weight-for-age z-scores were significantly increased compared with the baseline, but not after 1 year of the GFD.
In CD, the first year of GFD is important in weight gain, linear growth, and improvement of BMD. A considerable relation of low BMD in children with CD, with respect to z-scores for CA, may be a result of misinterpretation of low BMD due to short stature.
背景/目的：评估儿童乳糜泻（CD）患者食用无麸质饮食（GFD）时的生长和骨骼代谢变化。
共纳入 37 名 CD 患儿（平均年龄 8.8±4.6 岁，21 名女性）。记录诊断时和随访时的人体测量学指标、腰椎 2-4 节段的骨矿物质密度（BMD）以及血清碱性磷酸酶、钙和磷水平。
平均随访时间为 3.5±2.3 年。患者的 BMD 在诊断时明显低于对照组，但在 GFD 治疗 1 年后则无差异。按实际年龄（CA）计算的 BMD 低发生率明显高于按身高年龄（HA）计算的发生率（P=0.006）。在 GFD 的第一年，BMD、BMD z 评分、身高 z 评分、体重 z 评分与基线相比显著增加，但在 GFD 治疗 1 年后则无差异。
在 CD 中，GFD 的第一年对体重增加、线性生长和 BMD 改善非常重要。CD 患儿的低 BMD 与 CA 相关 z 评分较低可能是由于身材矮小导致对低 BMD 的错误解释。
