Issn Print: 0277-2116

Publication Date: 2004/06/01


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PC46 BONE MINERAL DENSITY AFTER A LONG TERM GLUTEN FREE DIET IN CELIAC PATIENTS

I. A. Cura; I. Polanco; G. Prieto; M. Molina; J. Sarria

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Author Information: Servicio de Gastroenterologia y Nutricion Pediatrica, Hospital Infantil La Paz, Madrid, Spain

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Introduction: Celiac disease(CD) is a intolerance to dietary gluten in genetically predisposed individuals. Several srudies have demostrated that low bone mineral density (BMD) is present in adults and children with untreated CD. Some authors suggest that the dietary treatment with gluten free diet (GFD) is able to improve BMD levels in celiac patients. Measurement of ultrasound velocity(SoS) across the bone has been proposed as a complementary and alternative method to measure BMD.
Methods: The aim was assessed BMD by measuring ADSoS using DBM sonic 1200 device in celiac patients and evaluate the impact of long-term GFD. We examined 71 patients with CD diagnosed according to the ESPGHAN criteria on GFD>5 yr and compared the results with 30 healthy controls. We measured the amplitude dependent SoS (ADSoS) at the distal metaphysis of the first phalanx of the last 4 fingers of the non dominant hand. The results were compared with normal values according to sex and age.
Results: Median time in a GFD duration was 13.19+/−3.8 yr. The ADSoS measurements of celiac patients increased from 10 to 20 yr of 1885 to 2152 m/seg in males (14.77%) and in females increased 1889–2113 m/seg (11.6%,p < 0.001).The measurements did not differ from those of control subjects at the moment of this study (1998 +/−23 males vs 2007 +/−34 males).In both sex, the mean values of ADSoS increased progressively from 11 to 18 yrs. At age 12 to 16 yr females had significant higer values than males (P<0.01). Mean values of ADSoS did not differ between sex up to age 18 (p=0.19);ADSoS showing marked increased during puberty. ADSoS was directly correlated with age (r=0.88,p<0.001 in males and r=0.82,p<0.001 in females).In addition was directly correlated with heigth (r=0.75 and r=0.71 males vs females p<0.001). Patients who started GFD during puberty had BMD measurement comparable to those who started GFD before puberty.
Conclusion: Our data indicated the dietary treatment initiated during childhood or adolescence is able to mantain normal bone density after several years of GFD.

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