Dehghani Seyed Mohsen, Ilkhanipour Homa, Samipour Leila, Niknam Ramin, Shahramian Iraj, Parooie Fateme, Salarzaei Morteza, Tahani Masoud
Shiraz Transplant Research Center, Shiraz University of Medical Science, Shiraz, Iran.
Department of Pediatric, Shiraz University of Medical Science, Shiraz, Iran.
Pediatr Gastroenterol Hepatol Nutr. 2022 Mar;25(2):138-146. doi: 10.5223/pghn.2022.25.2.138. Epub 2022 Mar 10.
Children with celiac disease (CD) are at an increased risk of low bone mineral density (BMD) owing to malabsorption of fat-soluble vitamins, inflammation, and malnutrition. This study aimed to determine the prevalence and risk factors for low BMD in Iranian children with CD.
This prospective cohort study examined 149 Iranian children with CD between 2011 and 2018 at Zabol University of Medical Sciences. BMD was measured using dual-energy X-ray absorptiometry. Demographic, clinical, and laboratory data were collected from patients medical records. Logistic regression analysis was performed to identify the factors associated with low areal BMD (BMD-Z <-2) in the lumbar spine and femoral neck. Descriptive data were analyzed using the mean, standard deviation, and relative frequency. Data were analyzed using the chi-square test, -test, and analysis of variance.
Of the 149 children with CD, 27.5% had osteoporosis. The mean body mass index (BMI) Z score was -1.28±1.2. Lower BMI was associated with a higher likelihood of BMD-Z (odds ratio 2.17; ≤0.05).
Overall, the findings of this study showed that there was no correlation among Marsh classification, presence of specific human leukocyte antigens, and low BMD in Iranian children with CD. BMI can be a predictor of bone density in children with CD and may be applied clinically in early screenings to evaluate the bone health status in these children.
由于脂溶性维生素吸收不良、炎症和营养不良，患有乳糜泻（CD）的儿童骨矿物质密度（BMD）低的风险增加。本研究旨在确定伊朗CD患儿低BMD的患病率和危险因素。
这项前瞻性队列研究在扎博勒医科大学对2011年至2018年间的149名伊朗CD患儿进行了检查。使用双能X线吸收法测量BMD。从患者病历中收集人口统计学、临床和实验室数据。进行逻辑回归分析以确定与腰椎和股骨颈低面积BMD（BMD-Z<-2）相关的因素。描述性数据采用均值、标准差和相对频率进行分析。数据采用卡方检验、t检验和方差分析。
在149名CD患儿中，27.5%患有骨质疏松症。平均体重指数（BMI）Z评分为-1.28±1.2。较低的BMI与BMD-Z较高的可能性相关（比值比2.17；P≤0.05）。
总体而言，本研究结果表明，在伊朗CD患儿中，马什分类、特定人类白细胞抗原的存在与低BMD之间无相关性。BMI可作为CD患儿骨密度的预测指标，临床上可用于早期筛查，以评估这些患儿的骨骼健康状况。
