Bone Metabolism Defects Common in Untreated Children With Celiac Disease

The calcium metabolism defects that are prevalent in children with untreated celiac disease resolve after a gluten-free diet has begun, concludes an Italian study team in the August issue of the Journal of Pediatrics.

They compared serum levels of calcium, magnesium, 25(OH) vitamin D3, alkaline phosphatase and parathyroid hormone of CD patients. Compared with the controls, children with celiac disease had significantly lower concentrations of calcium and 25(OH) vitamin D3 and significantly higher concentrations of parathyroid hormone (p < 0.001). Twenty-nine subjects (53.7%) with celiac disease had hyperparathyroidism.

Of the 20 children with celiac disease who tested positive for two alterations on laboratory measurement and underwent dual energy X-ray absorptiometry (DEXA), 10 were osteopenic (z-score between –1 and –2.5).

"In line with other studies involving children diagnosed with celiac disease before 9 years of age," the authors note, all the laboratory findings returned to normal after 6 months of a gluten-free diet, with improvement in bone mineral density and resolution of osteopenia.

These observations, they say, confirm that in this population at least, "bone metabolism abnormalities are part of the gluten-dependent clinical picture of celiac disease."

Bonnie - what a well conceived and important study for the medical community to take note of. Of course bone metabolism will be an issue for those with celiac disease who are still eating gluten. Simply, the malabsorption issues one has with celiac or gluten intolerance will not allow minerals such as calcium to be adequately utilized. Hence, when gluten is removed, absorption becomes normal again.